§ 58‑65‑94. Coverage of certain prescribed drugs for cancer treatment.
(a) No insurancecertificate or subscriber contract under any hospital service plan or medicalservice plan governed by this Article and Article 66 of this Chapter, and nopreferred provider benefit plan under G.S. 58‑50‑56, that isissued, renewed, or amended on or after January 1, 1994, and that providescoverage for prescribed drugs approved by the federal Food and DrugAdministration for the treatment of certain types of cancer shall excludecoverage of any drug on the basis that the drug has been prescribed for thetreatment of a type of cancer for which the drug has not been approved by thefederal Food and Drug Administration. The drug, however, must be approved bythe federal Food and Drug Administration and must have been proven effectiveand accepted for the treatment of the specific type of cancer for which thedrug has been prescribed in any one of the following established referencecompendia:
(1) The NationalComprehensive Cancer Network Drugs & Biologics Compendium;
(2) TheThomsonMicromedex DrugDex;
(3) The Elsevier GoldStandard's Clinical Pharmacology; or
(4) Any otherauthoritative compendia as recognized periodically by the United StatesSecretary of Health and Human Services.
(b) Notwithstandingsubsection (a) of this section, coverage shall not be required for anyexperimental or investigational drugs or any drug that the federal Food andDrug Administration has determined to be contraindicated for treatment of thespecific type of cancer for which the drug has been prescribed.
(c) This section shallapply only to cancer drugs and nothing in this section shall be construed,expressly or by implication, to create, impair, alter, limit, notify, enlarge,abrogate, or prohibit reimbursement for drugs used in the treatment of anyother disease or condition. (1993, c. 506, s. 4.2; 1997‑519, s. 3.8; 2009‑170,s. 2.)
§ 58‑65‑94. Coverage of certain prescribed drugs for cancer treatment.
(a) No insurancecertificate or subscriber contract under any hospital service plan or medicalservice plan governed by this Article and Article 66 of this Chapter, and nopreferred provider benefit plan under G.S. 58‑50‑56, that isissued, renewed, or amended on or after January 1, 1994, and that providescoverage for prescribed drugs approved by the federal Food and DrugAdministration for the treatment of certain types of cancer shall excludecoverage of any drug on the basis that the drug has been prescribed for thetreatment of a type of cancer for which the drug has not been approved by thefederal Food and Drug Administration. The drug, however, must be approved bythe federal Food and Drug Administration and must have been proven effectiveand accepted for the treatment of the specific type of cancer for which thedrug has been prescribed in any one of the following established referencecompendia:
(1) The NationalComprehensive Cancer Network Drugs & Biologics Compendium;
(2) TheThomsonMicromedex DrugDex;
(3) The Elsevier GoldStandard's Clinical Pharmacology; or
(4) Any otherauthoritative compendia as recognized periodically by the United StatesSecretary of Health and Human Services.
(b) Notwithstandingsubsection (a) of this section, coverage shall not be required for anyexperimental or investigational drugs or any drug that the federal Food andDrug Administration has determined to be contraindicated for treatment of thespecific type of cancer for which the drug has been prescribed.
(c) This section shallapply only to cancer drugs and nothing in this section shall be construed,expressly or by implication, to create, impair, alter, limit, notify, enlarge,abrogate, or prohibit reimbursement for drugs used in the treatment of anyother disease or condition. (1993, c. 506, s. 4.2; 1997‑519, s. 3.8; 2009‑170,s. 2.)
§ 58‑65‑94. Coverage of certain prescribed drugs for cancer treatment.
(a) No insurancecertificate or subscriber contract under any hospital service plan or medicalservice plan governed by this Article and Article 66 of this Chapter, and nopreferred provider benefit plan under G.S. 58‑50‑56, that isissued, renewed, or amended on or after January 1, 1994, and that providescoverage for prescribed drugs approved by the federal Food and DrugAdministration for the treatment of certain types of cancer shall excludecoverage of any drug on the basis that the drug has been prescribed for thetreatment of a type of cancer for which the drug has not been approved by thefederal Food and Drug Administration. The drug, however, must be approved bythe federal Food and Drug Administration and must have been proven effectiveand accepted for the treatment of the specific type of cancer for which thedrug has been prescribed in any one of the following established referencecompendia:
(1) The NationalComprehensive Cancer Network Drugs & Biologics Compendium;
(2) TheThomsonMicromedex DrugDex;
(3) The Elsevier GoldStandard's Clinical Pharmacology; or
(4) Any otherauthoritative compendia as recognized periodically by the United StatesSecretary of Health and Human Services.
(b) Notwithstandingsubsection (a) of this section, coverage shall not be required for anyexperimental or investigational drugs or any drug that the federal Food andDrug Administration has determined to be contraindicated for treatment of thespecific type of cancer for which the drug has been prescribed.
(c) This section shallapply only to cancer drugs and nothing in this section shall be construed,expressly or by implication, to create, impair, alter, limit, notify, enlarge,abrogate, or prohibit reimbursement for drugs used in the treatment of anyother disease or condition. (1993, c. 506, s. 4.2; 1997‑519, s. 3.8; 2009‑170,s. 2.)
