- A person aggrieved by a decision of the board may appeal the decision within sixty days after the decision is made. The board shall consider the appeal and issue a final decision concerning the appeal within sixty days after the board receives the appeal.
- Not later than March 31, 2022, the board shall promulgate rules establishing a process and timeline for the consideration by the board of any appeal that is submitted to the board pursuant to subsection (1) of this section. The process and timeline must comport with the “State Administrative Procedure Act”, article 4 of title 24.
- In the absence of an appeal, a decision of the board becomes final and ripe for judicial review after sixty days. Any person aggrieved by a final decision of the board may petition for judicial review pursuant to section 24-4-106.
- Notwithstanding any provision of law to the contrary:
- An individual may request an expedited review, as described in section 10-16-113.5, of access to a prescription drug that is unavailable to the individual because a manufacturer refuses to make the drug available as a result of an upper payment limit established for the prescription drug by the board; and
- A carrier may disregard the upper payment limit if the independent external review entity that performs the expedited review determines pursuant to such review that the prescription drug should be covered for and available to that individual.
Source: L. 2021: Entire part added, (SB 21-175), ch. 240, p. 1270, § 2, effective June 16.