Indiana Code 27-8-20-7. Exclusion of coverage for drugs not approved by the FDA; limitations
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Sec. 7. An insurance policy or a health maintenance organization that provides coverage for drugs may not exclude coverage of a covered drug for a particular indication on the grounds that the drug has not been approved by the federal Food and Drug Administration for the particular indication if any of the following conditions are met:
(2) The drug is recommended for that particular type of cancer and found to be safe and effective in formal clinical studies, the results of which have been published in a peer reviewed professional medical journal published in the United States or Great Britain.
(1) The drug is recognized for treatment of the indication in at least one (1) standard reference compendium.
Terms Used In Indiana Code 27-8-20-7
- drug: means a drug or biologic that is used in an anticancer chemotherapeutic regimen. See Indiana Code 27-8-20-2
- health maintenance organization: has the meaning set forth in IC 27-13-1-19. See Indiana Code 27-8-20-5
- insurance policy: means an accident and sickness policy (as defined in IC 27-8-5-1). See Indiana Code 27-8-20-3
- standard reference compendium: means any of the following:
Indiana Code 27-8-20-6
- United States: includes the District of Columbia and the commonwealths, possessions, states in free association with the United States, and the territories. See Indiana Code 1-1-4-5
As added by P.L.277-1993(ss), SEC.120. Amended by P.L.26-1994, SEC.20.