Insurer may not exclude certain off-label uses of prescription drugs.

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58-17-101. Insurer may not exclude certain off-label uses of prescription drugs.

No health insurer issuing a policy which provides coverage for prescription drugs may exclude coverage of any drug used for the treatment of cancer or life threatening conditions on the grounds that the drug has not been approved by the FDA for that indication if that drug is recognized for treatment of such indication in one of the standard reference compendia or in the medical literature. The prescribing physician shall submit documentation supporting the proposed off-label use or uses to the insurer, if requested. Any coverage of a drug that serves as the primary treatment required by §§58-17-100 to 58-17-106, inclusive, shall also include medically necessary services associated with the administration of the drug.

Source: SL 2000, ch 242, §2.


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