550.1416a Coverage for drug used in antineoplastic therapy and cost of its administration; conditions.
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550.1416a Coverage for drug used in antineoplastic therapy and cost of its administration; conditions.
Sec. 416a.
A health care corporation shall provide coverage in each group and nongroup certificate for a federal food and drug administration approved drug used in antineoplastic therapy and the reasonable cost of its administration. Coverage shall be provided regardless of whether the specific neoplasm for which the drug is being used as treatment is the specific neoplasm for which the drug has received approval by the federal food and drug administration if all of the following conditions are met:
(a)The drug is ordered by a physician for the treatment of a specific type of neoplasm.
(b)The drug is approved by the federal food and drug administration for use in antineoplastic therapy.
(c)The drug is used as part of an antineoplastic drug regimen.
(d)Current medical literature substantiates its efficacy and recognized oncology organizations generally accept the treatment.
(e)The physician has obtained informed consent from the patient for the treatment regimen which includes federal food and drug administration approved drugs for off-label indications.
History: Add. 1989, Act 57, Imd. Eff. June 16, 1989
Popular Name: Blue Cross-Blue Shield
Popular Name: Act 350