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