{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3407.6_1.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3407.6_1.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3407.6_1.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3407.6_1.html"}],"law_id":74649,"edition_id":1,"section_id":74649,"structure_id":12994,"section_number":"38.2-3407.6:1","catch_line":"Denial of benefits for certain prescription drugs prohibited","history":"1999, c. 857.","full_text":"A\n\nEach (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription contracts, and (iii) health maintenance organization providing a health care plan for health care services, whose policy, contract or plan, including any certificate or evidence of coverage issued in connection with such policy, contract or plan, includes coverage for prescription drugs, whether on an inpatient basis, an outpatient basis, or both, shall provide in each such policy, contract, plan, certificate, and evidence of coverage that such benefits shall not be denied for any drug approved by the United States Food and Drug Administration for use in the treatment of cancer pain on the basis that the dosage is in excess of the recommended dosage of the pain-relieving agent, if the prescription in excess of the recommended dosage has been prescribed in compliance with §§ 54.1-2971.01, 54.1-3303 and 54.1-3408.1 for a patient with intractable cancer pain.B\n\nThe provisions of this section shall not apply to short-term travel, or accident-only policies, or to short-term nonrenewable policies of not more than six months’ duration.C\n\nThe provisions of this section are applicable to contracts, policies or plans delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1999.","order_by":null,"text":{"0":{"id":268286,"text":"Each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription contracts, and (iii) health maintenance organization providing a health care plan for health care services, whose policy, contract or plan, including any certificate or evidence of coverage issued in connection with such policy, contract or plan, includes coverage for prescription drugs, whether on an inpatient basis, an outpatient basis, or both, shall provide in each such policy, contract, plan, certificate, and evidence of coverage that such benefits shall not be denied for any drug approved by the United States Food and Drug Administration for use in the treatment of cancer pain on the basis that the dosage is in excess of the recommended dosage of the pain-relieving agent, if the prescription in excess of the recommended dosage has been prescribed in compliance with §§ 54.1-2971.01, 54.1-3303 and 54.1-3408.1 for a patient with intractable cancer pain.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":268287,"text":"The provisions of this section shall not apply to short-term travel, or accident-only policies, or to short-term nonrenewable policies of not more than six months’ duration.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":268288,"text":"The provisions of this section are applicable to contracts, policies or plans delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1999.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B"}},"ancestry":[{"id":12994,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214889,"object_type":"structure","relational_id":12994,"identifier":"1","token":"38.2\/34\/1","url":"\/38.2\/34\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness Insurance","identifier":"34","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214887,"object_type":"structure","relational_id":12993,"identifier":"34","token":"38.2\/34","url":"\/38.2\/34\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":57593,"structure_id":12994,"section_number":"38.2-3400","catch_line":"Application of chapter","url":"\/38.2-3400\/","token":"38.2\/34\/1\/38.2-3400","metadata":false},{"id":72072,"structure_id":12994,"section_number":"38.2-3401","catch_line":"Forms of insurance 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circumstances","url":"\/38.2-3407.6\/","token":"38.2\/34\/1\/38.2-3407.6","metadata":false},"next_section":{"id":72641,"structure_id":12994,"section_number":"38.2-3407.7","catch_line":"Pharmacies; freedom of choice","url":"\/38.2-3407.7\/","token":"38.2\/34\/1\/38.2-3407.7","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3407.6:1\/","history_text":"

This law was first created in 1999. The record of its establishment is cataloged in chapter 857<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year.<\/p>","references":[{"id":84333,"section_number":"38.2-3406.1","catch_line":"Application of requirements that policies offered by small employers include state-mandated health benefits","order_by":null,"url":"\/38.2-3406.1\/"},{"id":55347,"section_number":"38.2-4214","catch_line":"Application of certain provisions of law","order_by":null,"url":"\/38.2-4214\/"},{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"}],"refers_to":[{"id":57814,"section_number":"54.1-2971.01","catch_line":"Prescription in excess of recommended dosage in certain cases","order_by":null,"url":"\/54.1-2971.01\/"},{"id":85347,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","order_by":null,"url":"\/54.1-3303\/"},{"id":82403,"section_number":"54.1-3408.1","catch_line":"Prescription in excess of recommended dosage in certain cases","order_by":null,"url":"\/54.1-3408.1\/"}],"permalink":{"id":215107,"object_type":"law","relational_id":74649,"identifier":"38.2-3407.6:1","token":"38.2\/34\/1\/38.2-3407.6_1","url":"\/38.2-3407.6_1\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3407.6_1\/","token":"38.2\/34\/1\/38.2-3407.6_1","dublin_core":{"Title":"Denial of benefits for certain prescription drugs prohibited","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3407.6:1","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Each (i) insurer<\/span> proposing to issue<\/span> individual or group accident and sickness insurance policies<\/span> providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription contracts<\/span>, and (iii) health maintenance organization providing a health care plan for health care services, whose policy, contract<\/span> or plan, including any certificate or evidence<\/span> of coverage issued in connection with such policy, contract<\/span> or plan, includes coverage for prescription drugs, whether on an inpatient basis, an outpatient basis, or both, shall provide in each such policy, contract<\/span>, plan, certificate, and evidence<\/span> of coverage that such benefits shall not be denied for any drug approved by the United States<\/span> Food and Drug Administration for use in the treatment of cancer pain on the basis that the dosage is in excess of the recommended dosage of the pain-relieving agent, if the prescription in excess of the recommended dosage has been prescribed in compliance with §§ 54.1-2971.01<\/a>, 54.1-3303<\/a> and 54.1-3408.1<\/a> for a patient with intractable cancer pain. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The provisions of this section shall not apply to short-term travel, or accident-only policies, or to short-term nonrenewable policies of not more than six months’ duration. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The provisions of this section are applicable to contracts<\/span>, policies or plans delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1999. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nDENIAL OF BENEFITS FOR CERTAIN PRESCRIPTION DRUGS PROHIBITED (\u00a7 38.2-3407.6:1)\n\nA. Each (i) insurer proposing to issue individual or group accident and sickness\ninsurance policies providing hospital, medical and surgical or major medical\ncoverage on an expense-incurred basis, (ii) corporation providing individual or\ngroup accident and sickness subscription contracts, and (iii) health maintenance\norganization providing a health care plan for health care services, whose\npolicy, contract or plan, including any certificate or evidence of coverage\nissued in connection with such policy, contract or plan, includes coverage for\nprescription drugs, whether on an inpatient basis, an outpatient basis, or both,\nshall provide in each such policy, contract, plan, certificate, and evidence of\ncoverage that such benefits shall not be denied for any drug approved by the\nUnited States Food and Drug Administration for use in the treatment of cancer\npain on the basis that the dosage is in excess of the recommended dosage of the\npain-relieving agent, if the prescription in excess of the recommended dosage\nhas been prescribed in compliance with §§ 54.1-2971.01, 54.1-3303 and\n54.1-3408.1 for a patient with intractable cancer pain.\n\nB. The provisions of this section shall not apply to short-term travel, or\naccident-only policies, or to short-term nonrenewable policies of not more than\nsix months’ duration.\n\nC. The provisions of this section are applicable to contracts, policies or plans\ndelivered, issued for delivery or renewed in this Commonwealth on and after July\n1, 1999.\n\nHISTORY: 1999, c. 857.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}