Sec. 38a-492b. Coverage for off-label drug prescriptions.
Sec. 38a-492b. Coverage for off-label drug prescriptions. (a) Each individual
health insurance policy delivered, issued for delivery or renewed in this state on or after
October 1, 1994, which provides coverage for prescribed drugs approved by the federal
Food and Drug Administration for treatment of certain types of cancer shall not exclude
coverage of any such drug on the basis that such drug has been prescribed for the treatment of a type of cancer for which the drug has not been approved by the federal Food
and Drug Administration, provided the drug is recognized for treatment of the specific
type of cancer for which the drug has been prescribed in one of the following established
reference compendia: (1) The U.S. Pharmacopoeia Drug Information Guide for the
Health Care Professional (USP DI); (2) The American Medical Association's Drug
Evaluations (AMA DE); or (3) The American Society of Hospital Pharmacists' American Hospital Formulary Service Drug Information (AHFS-DI).
(b) Nothing in subsection (a) of this section shall be construed to require coverage
for any experimental or investigational drugs or any drug which the federal Food and
Drug Administration has determined to be contraindicated for treatment of the specific
type of cancer for which the drug has been prescribed.
(c) Nothing in this section shall be construed to create, impair, limit or modify
authority to provide reimbursement for drugs used in the treatment of any other disease
or condition.
(P.A. 94-49, S. 2.)
See Sec. 38a-518b for similar provisions re group policies.