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§ 5704.103. Utilization management for stage four, advanced metastatic cancer drugs

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 35 P.S. Health and SafetyEffective: April 13, 2020

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 35 P.S. Health and Safety (Refs & Annos)
Chapter 27H. Fair Access to Cancer Treatment Act
Effective: April 13, 2020
35 P.S. § 5704.103
§ 5704.103. Utilization management for stage four, advanced metastatic cancer drugs
Currentness
A health insurance carrier or health insurance policy that, directly or indirectly, covers the treatment of stage four, advanced metastatic cancer may not require an enrollee to first fail to successfully respond to a different drug, or prove a history of failure in use of a different drug, before providing coverage for a covered drug to which both of the following apply:
(1) The drug is approved by the United States Food and Drug Administration for this indication.
(2) The prescription of the drug is consistent with the best clinical practices for the treatment of stage four, advanced metastatic cancer or a severe adverse health condition experienced as a result of stage four, advanced metastatic cancer, and is supported by peer-reviewed medical literature.

Credits

2020, Feb. 12, P.L. 11, No. 6, § 3, effective in 60 days [April 13, 2020].
35 P.S. § 5704.103, PA ST 35 P.S. § 5704.103
Current through 2023 Regular Session Act 1. Some statute sections may be more current, see credits for details.
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