<?xml version="1.0"?>
<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>71393</law_id><section_number>38.2-3407.11:2</section_number><catch_line>Standing referral for cancer patients</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="34">Provisions Relating to Accident and Sickness Insurance</unit><unit label="article" level="3" order_by="1" identifier="1">General Provisions</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> Each (i) <span class="dictionary">insurer</span> proposing to <span class="dictionary">issue</span> individual or group accident and sickness <span class="dictionary">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 <span class="dictionary">contracts</span>, and (iii) health maintenance organization providing a health care plan for health care services, whose policies, <span class="dictionary">contracts</span> or plans, including any certificate or <span class="dictionary">evidence</span> of coverage issued in connection with such policies, <span class="dictionary">contracts</span> or plans, shall have a procedure in place to permit any individual covered thereunder who has been diagnosed with cancer to have a standing referral to a board-certified physician in pain management or oncologist who is authorized to provide services under such policy, <span class="dictionary">contract</span> or plan and has been selected by the cancer patient. <a id="paragraph-257397" class="section-permalink" href="https://vacode.org/38.2-3407.11_2/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> The board-certified physician in pain management or oncologist shall consult on a regular basis, as required under the terms of the policy, <span class="dictionary">contract</span> or plan, by telephone or through written communication, with the primary care physician and any oncologist providing care to the patient concerning the plan of pain management for the patient. Further, this section shall not be construed to authorize the board-certified physician in pain management or oncologist to direct the patient to other health care services. <a id="paragraph-257398" class="section-permalink" href="https://vacode.org/38.2-3407.11_2/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> Nothing contained herein shall prohibit an <span class="dictionary">insurer</span>, corporation, or health maintenance organization from requiring a participating board-certified physician in pain management or oncologist to provide written notification to the cancer patient&#x2019;s primary care physician of any visit to him. Such notification may include a description of the health care services rendered at the time of the visit. <a id="paragraph-257399" class="section-permalink" href="https://vacode.org/38.2-3407.11_2/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> Each <span class="dictionary">insurer</span>, corporation or health maintenance organization subject to the provisions of this section shall inform subscribers, in writing, within the policy or <span class="dictionary">evidence</span> of coverage of the provisions of this section. <a id="paragraph-257400" class="section-permalink" href="https://vacode.org/38.2-3407.11_2/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> The requirements of this section shall apply to all <span class="dictionary">insurance policies</span>, <span class="dictionary">contracts</span>, and plans delivered, issued for delivery, reissued, renewed, or extended or at any time when any term of any such policy, <span class="dictionary">contract</span>, or plan is changed or any premium adjustment is made. The provisions of this section shall not apply to short-term travel or accident-only policies, to short-term nonrenewable policies of not more than six months&#x2019; duration, or policies or <span class="dictionary">contracts</span> issued to <span class="dictionary">persons</span> eligible under Title XVIII of the Social Security Act, known as <span class="dictionary">Medicare</span>, or any other similar coverage under <span class="dictionary">state</span> or federal governmental plans. <a id="paragraph-257401" class="section-permalink" href="https://vacode.org/38.2-3407.11_2/#E"><i class="fa fa-link"/></a></p></section></text><history>1999, c. 856.</history><metadata></metadata></law>
