§ 58-51-59. Coverage of certain prescribed drugs for cancer treatment. - North Carolina Statutes

§ 58‑51‑59. Coverage of certain prescribed drugs for cancer treatment.

(a)        No policy orcontract of accident or health insurance, and no preferred provider benefitplan under G.S. 58‑50‑56, that is issued, renewed, or amended on orafter January 1, 1994, and that provides coverage for prescribed drugs approvedby the federal Food and Drug Administration for the treatment of certain typesof cancer shall exclude coverage of any drug on the basis that the drug hasbeen prescribed for the treatment of a type of cancer for which the drug hasnot been approved by the federal Food and Drug Administration. The drug,however, must be approved by the federal Food and Drug Administration and musthave been proven effective and accepted for the treatment of the specific typeof cancer for which the drug has been prescribed in any one of the followingestablished reference compendia:

(1)        The NationalComprehensive Cancer Network Drugs & Biologics Compendium;

(2)        TheThomsonMicromedex DrugDex;

(3)        The Elsevier GoldStandard's Clinical Pharmacology; or

(4)        Any otherauthoritative compendia as recognized periodically by the United StatesSecretary of Health and Human Services.

(b)        Notwithstandingsubsection (a) of this section, coverage shall not be required for any experimentalor investigational drugs or any drug that the federal Food and DrugAdministration has determined to be contraindicated for treatment of thespecific type of cancer for which the drug has been prescribed.

(c)        This section shallapply only to cancer drugs and nothing in this section shall be construed,expressly or by implication, to create, impair, alter, limit, notify, enlarge,abrogate, or prohibit reimbursement for drugs used in the treatment of anyother disease or condition.  (1993, c. 506, s. 4.1; 1997‑519, s. 3.5; 2009‑170,s. 1.)