Insights

Prescription Drug Coverage Related to Stage Four Advanced Metastatic Cancer


HB 427 requires policies issued or renewed on or after October 9, 2020, which provide coverage for the treatment of stage four advanced metastatic cancer to provide coverage for prescription drugs related to the treatment of such cancer. Specifically, the insurer may not require an insured to first fail to successfully respond to a different drug or prove a history of failure with a different drug before providing coverage for a covered drug if it is approved by the FDA is consistent with the best clinical practices for the treatment of stage four advanced metastatic cancer or a related severe adverse health condition.

Employers should be aware of this insurance mandate.

HB427 »