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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>81770</law_id><section_number>38.2-3407.18</section_number><catch_line>Requirements for orally administered cancer chemotherapy drugs</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, include coverage for cancer chemotherapy drugs administered orally and intravenously or by injection shall provide that the criteria for establishing cost sharing applicable to orally administered cancer chemotherapy drugs and cancer chemotherapy drugs that are administered intravenously or by injection shall be consistently applied within the same plan. <a id="paragraph-292982" class="section-permalink" href="https://vacode.org/38.2-3407.18/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</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, on and after the effective date of this section. The provisions of this section shall not apply to short-term travel, accident only, or limited or specified disease policies or <span class="dictionary">contracts</span>, nor to policies or <span class="dictionary">contracts</span> designed for issuance to <span class="dictionary">persons</span> eligible for coverage 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-292983" class="section-permalink" href="https://vacode.org/38.2-3407.18/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> This section shall apply to health coverage offered to <span class="dictionary">state</span> employees pursuant to &#xA7; <a class="law" title="Health and related insurance for state employees" href="/2.2-2818/">2.2-2818</a> and to health insurance coverage offered to employees of local governments, local officers, teachers, and retirees, and the dependents of such employees, local officers, teachers and retirees pursuant to &#xA7; <a class="law" title="Health insurance program for employees of local governments, local officers, teachers, etc.; definitions" href="/2.2-1204/">2.2-1204</a>. In administering such coverage, the criteria for establishing the level of copayments or coinsurance for orally administered cancer treatment drugs and cancer chemotherapy drugs that are administered intravenously or by injection shall be consistently applied within the same plan. <a id="paragraph-292984" class="section-permalink" href="https://vacode.org/38.2-3407.18/#C"><i class="fa fa-link"/></a></p></section></text><history>2012, cc. 634, 641; 2014, c. 814.</history><metadata></metadata></law>
