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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>74649</law_id><section_number>38.2-3407.6:1</section_number><catch_line>Denial of benefits for certain prescription drugs prohibited</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-3406.1</reference><reference>38.2-4214</reference><reference>38.2-4319</reference></referred_to_by><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 policy, <span class="dictionary">contract</span> or plan, including any certificate or <span class="dictionary">evidence</span> of coverage issued in connection with such policy, <span class="dictionary">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, <span class="dictionary">contract</span>, plan, certificate, and <span class="dictionary">evidence</span> of coverage that such benefits shall not be denied for any drug approved by the United <span class="dictionary">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 &#xA7;&#xA7; <a class="law" title="Prescription in excess of recommended dosage in certain cases" href="/54.1-2971.01/">54.1-2971.01</a>, <a class="law" title="Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only" href="/54.1-3303/">54.1-3303</a> and <a class="law" title="Prescription in excess of recommended dosage in certain cases" href="/54.1-3408.1/">54.1-3408.1</a> for a patient with intractable cancer pain. <a id="paragraph-268286" class="section-permalink" href="https://vacode.org/38.2-3407.6_1/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">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&#x2019; duration. <a id="paragraph-268287" class="section-permalink" href="https://vacode.org/38.2-3407.6_1/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The provisions of this section are applicable to <span class="dictionary">contracts</span>, policies or plans delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1999. <a id="paragraph-268288" class="section-permalink" href="https://vacode.org/38.2-3407.6_1/#C"><i class="fa fa-link"/></a></p></section></text><history>1999, c. 857.</history><metadata></metadata></law>
