Regulations
| 9792.27.17....Formulary - Dispute Resolution | |
| Â Disputes over the medical necessity of pharmaceutical treatment covered by the MTUS Drug Formulary are governed by the utilization review and independent medical ...more | |
| 9792.27.18....Pharmacy and Therapeutics Committee - Composition; Application for Appointment; Term of Service | |
| Â (b) The P&T Committee shall consist of the Executive Medical Director, and six members appointed by the Administrative Director. Â (1) The Executive Medical ...more | |
| 9792.27.19....Pharmacy and Therapeutics Committee - Application for Appointment to Committee Form | |
| Pharmacy and Therapeutics Committee - Application for Appointment to Committee Form Note: Authority cited: Sections 133, 4603. 5, 5307. 3 and 5307. 27, Labor Code. ...more | |
| 9792.27.2....MTUS Drug Formulary; MTUS Drug List; Scope of Coverage; Effective Date | |
| Â (b) Except for continuing drug treatment subject to section 9792. 27. 3, subdivision (b), a drug dispensed on or after January 1, 2018 for outpatient use shall be ...more | |
| 9792.27.20....Pharmacy and Therapeutics Committee - Conflict of Interest | |
| Appointed members of the P&T Committee must impartially perform formulary update review activities, and must be free of conflicts of interest. A P&T Committee member who ...more | |
| 9792.27.21....Pharmacy and Therapeutics Committee - Conflict of Interest Disclosure Form | |
| Pharmacy and Therapeutics Committee - Conflict of Interest Disclosure Form Note: Authority cited: Sections 133, 4603. 5, 5307. 3 and 5307. 27, Labor Code. Reference: ...more | |
| 9792.27.22....Pharmacy and Therapeutics Committee - Meetings | |
| (a) The P&T Committee shall meet when deemed necessary by the Executive Medical Director, but no less frequently than quarterly. Â (b) P&T Committee meetings shall be ...more | |
| 9792.27.23....MTUS Drug List Updates | |
| (a) The Administrative Director shall consult with the P&T Committee as needed on updates to the MTUS Drug List, which may be adopted by the Administrative Director on a ...more | |
| 9792.27.3....MTUS Drug Formulary Transition | |
| (a) Except as provided in subdivision (b), the MTUS Drug Formulary applies to drugs dispensed on or after January 1, 2018, regardless of the date of injury. Â (b)(1) ...more | |
| 9792.27.4....MTUS Drug Formulary - Pharmacy Networks; Pharmacy Benefit Manager Contracts | |
| Where an employer or insurer contracts pursuant to Labor Code section 4600. 2 with a pharmacy, a pharmacy benefit manager, or pharmacy network for the provision of drugs ...more | |
