State and Public School Life and Health Insurance Board — Requirements

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  1. (a) By the end of plan year 2017, the State and Public School Life and Health Insurance Board shall explore the evidence supporting opportunities for benefit modification informed by:

    1. (1) The Choosing Wisely Initiative;

    2. (2) Emerging therapies; and

    3. (3) Therapeutic alternatives to invasive surgical procedures, such as regenerative injection therapy.

  2. (b) By July 2018, the board shall:

    1. (1) Identify and consider implementation of pilot programs that include stepped therapy or center of excellence approaches, or both, for which evidence demonstrates cost savings to the plan; and

    2. (2) Identify opportunities to stimulate conversations between patients and providers about appropriate and necessary treatment, including treatment recommendations identified by the Choosing Wisely Initiative.


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