Step therapy override definition

Step therapy override means that the step therapy protocol is overridden in favor of coverage of the selected prescription drug of the prescribing health care provider because at least one of the conditions of subdivision 3, paragraph (a), exists.
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Examples of Step therapy override in a sentence

  • Step therapy override requests may take several days to be reviewed by the health plan or insurer.27,28 Enrollees whose STP override requests are denied may purchase the initially-prescribed drug by paying out of pocket the full retail price or may purchase the STP-required drug and only pay the insurer’s required co-pay/co-insurance.

  • Step therapy override requests may take several days to be reviewed by the health plan or insurer.

  • Such determination shall be based on a review of the patient's or health care provider's22 request for an override, along with supporting rationale and documentation;23 (6) "Step therapy override exception request", a written or electronic request from a24 patient’s health care provider for the step therapy protocol to be overridden in favor of immediate25 coverage of the health care provider’s preferred prescription drug.

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  • Step therapy override requests follow a procedure by which a prescriber documents to the plan/insurer why an enrollee should be allowed to skip one or more of a step therapy protocol’s steps.

  • Step therapy override requests must be accessible to and submitted by health care providers, and accepted by group purchasers electronically through secure electronic transmission, as described under section 62J.497, subdivision 5.

  • Step therapy override" means that the step therapy protocol is overridden in favor of coverage of the selected prescription drug of the prescribing health care provider because at least one of the conditions of subdivision 3, paragraph (a), exists.

Related to Step therapy override

  • Step therapy means a protocol or

  • Step therapy protocol means a protocol or program that establishes the specific

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