S.D. Admin. R. 67:16:14:20

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:16:14:20 - Notice to interested parties before drug placed on list - Opportunity for interested parties to present data, opinions, and arguments

Before the Division of Medical Services places a drug on its list of drugs that require prior authorization, the division shall provide an opportunity for interested parties to present data, opinions, and arguments concerning the placement of the drug on the list. The division shall notify interested parties of this opportunity. The notice shall be in writing and shall state where and when an interested party can present data, opinions, and arguments concerning the proposal.

When taking final action on the proposals, the division may accept or reject the P and T committee's recommendations and may consider any information provided to the department by an interested party.

When the division places a drug on the list, an interested party may request that the department secretary review the division's decision. The request for the review must be in writing, made to the department secretary, and made within 30 days following the placement of the drug on the list. The request must contain the following information:

(1) The drug's brand name;

(2) A summary, limited to two pages, of the clinical and/or economic reasons why the product should not be included on the list; and

(3) New information on the drug that has become available since the P and T committee's hearing on the drug.

The department secretary shall review the required information and determine whether to override the division's decision. The secretary shall provide a written notice of the final action to the interested party requesting the review.

S.D. Admin. R. 67:16:14:20

32 SDR 154, effective 3/22/2006.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.