Section 500.3616a - Coverage for drug used in antineoplastic therapy and cost of its administration; conditions.
THE INSURANCE CODE OF 1956 (EXCERPT)
Act 218 of 1956
500.3616a Coverage for drug used in antineoplastic therapy and cost of its administration; conditions.
Sec. 3616a.
An insurer which delivers, issues for delivery, or renews in this state a hospital, medical, or surgical expense incurred policy shall provide coverage in each policy for a federal food and drug administration approved drug used in antineoplastic therapy and the reasonable cost of its administration. Coverage shall be provided regardless of whether the specific neoplasm for which the drug is being used as treatment is the specific neoplasm for which the drug has received approval by the federal food and drug administration if all of the following conditions are met:
(a) The drug is ordered by a physician for the treatment of a specific type of neoplasm.
(b) The drug is approved by the federal food and drug administration for use in antineoplastic therapy.
(c) The drug is used as part of an antineoplastic drug regimen.
(d) Current medical literature substantiates its efficacy and recognized oncology organizations generally accept the treatment.
(e) The physician has obtained informed consent from the patient for the treatment regimen which includes federal food and drug administration approved drugs for off-label indications.
History: Add. 1989, Act 59, Imd. Eff. June 16, 1989
Popular Name: Act 218