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SCLD Update |
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| Other Topics in this Issue: Breast Cancer
Detection |
State-of-the-Art Treatment Three states—Louisiana, Mississippi, and Virginia—passed laws that prohibit designated insurers from excluding coverage for the off-label use of prescription drugs to treat cancer. In all states, such drugs must be recognized for treatment in a specified standard reference compendium or (in Louisiana or Mississippi) medical literature. The Louisiana law applies to specified insurers, including HMOs and PPOs, that cover cancer treatment. The coverage must include all medically necessary services associated with the administration of the drug; however, insurers are not required to cover drugs furnished without charge to participants in research trials, or drugs determined by the Food and Drug Administration (FDA) to be contraindicated. In Mississippi, the law applies to certain insurers and state health plans that cover prescription drugs, while the Virginia amendment extends applicability to public employee health plans. Neither Mississippi nor Virginia requires coverage for drugs determined by the FDA to be contraindicated or for experimental drugs not otherwise approved by the FDA for any indication. Clinical Trials Rhode Island enacted two measures that require specified individual and group insurers, including HMOs, to provide coverage for Phase II clinical trials for new therapies under investigation. |
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