                                 CODE OF VIRGINIA

REQUIREMENTS FOR ORALLY ADMINISTERED CANCER CHEMOTHERAPY DRUGS (§ 38.2-3407.18)

A. 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
policies, contracts, or plans, including any certificate or evidence of coverage
issued in connection with such policies, contracts, 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.

B. The requirements of this section shall apply to all insurance policies,
contracts, and plans delivered, issued for delivery, reissued, renewed, or
extended or at any time when any term of any such policy, contract, 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 contracts,
nor to policies or contracts designed for issuance to persons eligible for
coverage under Title XVIII of the Social Security Act, known as Medicare, or any
other similar coverage under state or federal governmental plans.

C. This section shall apply to health coverage offered to state employees
pursuant to &#xA7; 2.2-2818 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; 2.2-1204. 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.

HISTORY: 2012, cc. 634, 641; 2014, c. 814.