§432:1-616 - Chemotherapy services.
[§432:1-616] Chemotherapy services. (a)
All individual and group hospital and medical service plan contracts that
include coverage or benefits for the treatment of cancer shall provide payment
or reimbursement for all chemotherapy that is considered medically necessary as
defined in section 432E-1.4, including orally administered chemotherapy, at the
same copayment percentage or relative coinsurance amount as is applied to
intravenously administered chemotherapy; provided that this section shall not apply
to an accident only, specified disease, hospital indemnity, long-term care, or
other limited benefit health insurance policy.
(b) For the purposes of this section:
"Intravenously administered
chemotherapy" means a physician-prescribed cancer treatment that is
administered through injection directly into the patient's circulatory system
by a physician, physician assistant, nurse practitioner, nurse, or other
medical personnel under the supervision of a physician and in a hospital,
medical office, or other clinical setting.
"Oral chemotherapy" means a United
States Food and Drug Administration-approved, physician-prescribed cancer
treatment that is taken orally in the form of a tablet or capsule and may be
administered in a hospital, medical office, or other clinical setting or may be
delivered to the patient for self-administration under the direction or
supervision of a physician outside of a hospital, medical office, or other
clinical setting. [L 2009, c 168, §2]