(a) Upon written request of a health insurer, pharmacy benefits manager, or utilization review entity, the department shall grant in writing a waiver of the requirements of one or more provisions of Ins 2705.06 upon a showing by the health insurer, pharmacy benefits manager, or utilization review entity, that:

1. (1) The health insurer, pharmacy benefits manager, or utilization review entity has adopted or plans to adopt the use of a nationally recognized standard for ePA of prescription drugs, including but not limited to standards provided by the National Council for Prescription Drug Programs or an equivalent organization;
2. (2) One or more provisions in these rules prevent the effective use of the nationally recognized standard;
3. (3) The modifications permitted under Ins 2705.06(b) do not effectively address the conflict between the rule and the national standard; and
4. (4) The waiver request outlines with specificity the requested modification to the uniform requirements of this part that will eliminate the conflict.

(b) A health insurer, pharmacy benefits manager, or utilization review entity that has been granted a waiver pursuant to (a) above shall comply with all provisions of Ins 2705 except as expressly described in the department’s written document granting the waiver.

APPENDIX

Rule

Specific State Statute the Rule Implements

Ins 2701.01

RSA 400-A:15, I; RSA 420-J:7, II; RSA 420-J:12

Ins 2701.02

RSA 400-A:15, I; RSA 420-J:7, II; RSA 420-J:12

Ins 2701.03

RSA 400-A:15, I; RSA 420-J:3; RSA 420-J:7, II

Ins 2701.04

RSA 400-A:15, I; RSA 420-J:7, II; RSA 420-J:12; 45 CFR 156.230

Ins 2701.05

RSA 400-A:15, I; RSA 420-J:7, II(b); 45 CFR 156.235

Ins 2701.06

RSA 400-A:15, I; RSA 420-J:7, II(c)

Ins 2701.07

RSA 400-A:15, I; RSA 420-J:7, II; RSA 420-J:12

Ins 2701.08

RSA 400-A:15, I; RSA 420-J:7, II; RSA 420-J:12

Ins 2701.09

RSA 400-A:15, I; RSA 420-J:7, II(a)

Ins 2701.10

RSA 400-A:15, I; RSA 420-J:7, II(b); RSA 420-J:12

Ins 2701.11

RSA 400-A:15, I; RSA 420-J:7 III and IV; RSA 420-J:12

Ins 2701.12

RSA 400-A:15, I; RSA 420-J:7, II; RSA 420-J:12

Ins 2701.13

RSA 400-A:15, I; RSA 420-J:7, II; RSA 420-J:12

Ins 2701.14

RSA 400-A:15, I; RSA 541-A:22, IV

Ins 2702.01

RSA 400-A:15, I; RSA 415:18-a, VIII; 29 USC 1185a (HR 1424-117)

Ins 2702.02

RSA 400-A:15, I; RSA 415:18-a, VIII; 29 USC 1185a (HR 1424-117)

Ins 2702.03

RSA 400-A:15, I; RSA 415:18-a, VIII; 29 USC 1185a (HR 1424-117)

Ins 2702.04

RSA 400-A:15, I; RSA 415:18-a, VIII; 29 USC 1185a (HR 1424-117)

Ins 2702.05

RSA 400-A:15, I; RSA 415:18-a, VIII; RSA 541-A:22, IV

Ins 2703.01

RSA 420-J:3; RSA 420-J:5-a through 5-e

Ins 2703.02

RSA 420-J:1; RSA 420-J:2

Ins 2703.03

RSA 420-J:5-a

Ins 2703.04

RSA 420-J:5

Ins 2703.05

RSA 420-J:5-b

Ins 2703.06

RSA 420-J:5-c

Ins 2703.07

RSA 420-J:5-d

Ins 2703.08

RSA 420-J:5-e

Ins 2703.09

RSA 420-J:5-e

Ins 2704.01

RSA 400-A:15, I; RSA 415:26; RSA 402-N:2; RSA 420-J:7-b, X;

RSA 420-J:12

Ins 2704.02

RSA 318:1, XI; RSA 318:2; RSA 400-A:15, I; RSA 402-N:1;

RSA 415:26; RSA 420-G:2, IX; RSA 420-J:3, XIX; RSA 420-J:7-b, X; RSA 420-J:12

Ins 2704.03

RSA 400-A:15, I; RSA 402-N:2

Ins 2704.04

RSA 400-A:15, I; RSA 402-N:2; RSA 402-N:6

Ins 2704.05

RSA 400-A:15, I; RSA 402-N:4; RSA 415:26; RSA 420-J:7-b, X;

RSA 420-J:8-a, IV; RSA 420-J:12

Ins 2704.06

RSA 400-A:15, I; RSA 400-A:16; RSA 402-N:5RSA 415:26;

RSA 420-J:7-b, X; RSA 420-J:12

Ins 2704.07

RSA 400-A:15, I; RSA 400-A:16; RSA 400-A:17-24; RSA 402-N:2;

RSA 415:26; RSA 417; RSA 420-J:7-b, X; RSA 420-J:12; RSA 420-J:14

Ins 2704.08

RSA 400-A:15, I; RSA 402-N:5, II; RSA 415:26; RSA 420:J:7-b, X;

RSA 420-J:12

Ins 2704.09

RSA 400-A:15, I; RSA 400-A:16, III; RSA 402-N:6, II; RSA 420-J:10-12

Ins 2704.10

RSA 400-A:15, I; RSA 400-A:37; RSA 402-N:2; RSA 402-N:7

Ins 2704.11

RSA 400-A:15, I; RSA 400-A:16, II; RSA 402-N:2

Ins 2704.12

RSA 400-A:15, I; RSA 541-A:22, IV

Ins 2705.01

RSA 400-A:15, I; 420-E:4-a, III; 420-J:7-b, IV-c (c)

Ins 2705.02

RSA 400-A:15, I; 420-E:4-a, III; 420-J:7-b, IV-c (c)

Ins 2705.03

RSA 400-A:15, I; 420-A:1; 420-B:1; 420-C:2; 420-E:4-a, II and III;

420-G:2; 420-J:7-b, IV-c (b) and (c)

Ins 2705.04

RSA 400-A:15, I; 420-E:4-a, III; 420-J:7-b, IV-c (c)

Ins 2705.05

RSA 400-A:15, I; 420-E:4-a, III; 420-J:7-b, IV-c

Ins 2705.06

RSA 400-A:15, I; 420-E:4-a, III; 420-J:7-b, IV-c ;

Pub. L. 104-191, Stat. 1936

Ins 2705.07

RSA 400-A:15, I; 420-E:4-a, III; 420-J:7-b, IV-c

Ins 2705.08

RSA 400-A:15, I

Ins 2705.09

RSA 400-A:15, I