§ 38.2-3407.6:1. Denial of benefits for certain prescription drugs prohibited.
A. Each (i) insurer proposing to issue individual or group accident andsickness insurance policies providing hospital, medical and surgical or majormedical coverage on an expense-incurred basis, (ii) corporation providingindividual or group accident and sickness subscription contracts, and (iii)health maintenance organization providing a health care plan for health careservices, whose policy, contract or plan, including any certificate orevidence of coverage issued in connection with such policy, contract or plan,includes coverage for prescription drugs, whether on an inpatient basis, anoutpatient basis, or both, shall provide in each such policy, contract, plan,certificate, and evidence of coverage that such benefits shall not be deniedfor any drug approved by the United States Food and Drug Administration foruse in the treatment of cancer pain on the basis that the dosage is in excessof the recommended dosage of the pain-relieving agent, if the prescription inexcess of the recommended dosage has been prescribed in compliance with §§54.1-2971.01, 54.1-3303 and 54.1-3408.1 for a patient with intractable cancerpain.
B. The provisions of this section shall not apply to short-term travel, oraccident-only policies, or to short-term nonrenewable policies of not morethan six months' duration.
C. The provisions of this section are applicable to contracts, policies orplans delivered, issued for delivery or renewed in this Commonwealth on andafter July 1, 1999.
§ 38.2-3407.6:1. Denial of benefits for certain prescription drugs prohibited.
A. Each (i) insurer proposing to issue individual or group accident andsickness insurance policies providing hospital, medical and surgical or majormedical coverage on an expense-incurred basis, (ii) corporation providingindividual or group accident and sickness subscription contracts, and (iii)health maintenance organization providing a health care plan for health careservices, whose policy, contract or plan, including any certificate orevidence of coverage issued in connection with such policy, contract or plan,includes coverage for prescription drugs, whether on an inpatient basis, anoutpatient basis, or both, shall provide in each such policy, contract, plan,certificate, and evidence of coverage that such benefits shall not be deniedfor any drug approved by the United States Food and Drug Administration foruse in the treatment of cancer pain on the basis that the dosage is in excessof the recommended dosage of the pain-relieving agent, if the prescription inexcess of the recommended dosage has been prescribed in compliance with §§54.1-2971.01, 54.1-3303 and 54.1-3408.1 for a patient with intractable cancerpain.
B. The provisions of this section shall not apply to short-term travel, oraccident-only policies, or to short-term nonrenewable policies of not morethan six months' duration.
C. The provisions of this section are applicable to contracts, policies orplans delivered, issued for delivery or renewed in this Commonwealth on andafter July 1, 1999.
§ 38.2-3407.6:1. Denial of benefits for certain prescription drugs prohibited.
A. Each (i) insurer proposing to issue individual or group accident andsickness insurance policies providing hospital, medical and surgical or majormedical coverage on an expense-incurred basis, (ii) corporation providingindividual or group accident and sickness subscription contracts, and (iii)health maintenance organization providing a health care plan for health careservices, whose policy, contract or plan, including any certificate orevidence of coverage issued in connection with such policy, contract or plan,includes coverage for prescription drugs, whether on an inpatient basis, anoutpatient basis, or both, shall provide in each such policy, contract, plan,certificate, and evidence of coverage that such benefits shall not be deniedfor any drug approved by the United States Food and Drug Administration foruse in the treatment of cancer pain on the basis that the dosage is in excessof the recommended dosage of the pain-relieving agent, if the prescription inexcess of the recommended dosage has been prescribed in compliance with §§54.1-2971.01, 54.1-3303 and 54.1-3408.1 for a patient with intractable cancerpain.
B. The provisions of this section shall not apply to short-term travel, oraccident-only policies, or to short-term nonrenewable policies of not morethan six months' duration.
C. The provisions of this section are applicable to contracts, policies orplans delivered, issued for delivery or renewed in this Commonwealth on andafter July 1, 1999.
