No group or blanket policy or contract of health insurance, or certificate issued thereunder which is delivered, issued for delivery, renewed, modified, altered, or amended in this State that directly or indirectly covers the treatment of cancer shall limit or exclude coverage for a drug approved by the United States Food and Drug Administration by mandating that the insured shall first be required to fail to successfully respond to a different drug or drugs or prove a history of failure of such drug or drugs; provided, however that the use of such drug or drugs is consistent with best practices for the treatment of stage 4 advanced, metastatic cancer or in the case of other cancers, the use of the drug is supported by national clinical guidelines, national standards of care, or for the treatment of the cancer, or in the case of targeted therapy, the target at issue.
Structure Delaware Code
Chapter 35. GROUP AND BLANKET HEALTH INSURANCE
Subchapter III. Provisions Applicable to Group and Blanket Health Insurance
§ 3552. Cancer screening tests.
§ 3553. Midwife services reimbursement.
§ 3555. Coverage of cancer monitoring tests.
§ 3555A. Equal reimbursement for oral and intravenous anticancer medication.
§ 3556. Obstetrical and gynecological coverage.
§ 3557. Child abuse or neglect — Group coverage.
§ 3558. Immunizations and preventive services.
§ 3559. Contraceptive coverage.
§ 3560. Insurance coverage for diabetes.
§ 3560A. Cost sharing in prescription insulin drugs.
§ 3560B. Coverage for insulin pumps.
§ 3561. Annual pap smear coverage reimbursement.
§ 3562. Colorectal cancer screening.
§ 3563. Required coverage for reconstructive surgery following mastectomy.
§ 3565A. Required coverage for volunteer ambulance company services.
§ 3566. Prescription medication.
§ 3567B. Experimental treatment coverage.
§ 3568. Newborn and infant hearing screening; coverage and reimbursement.
§ 3569. Use of Social Security numbers on insurance cards.
§ 3570A. Autism spectrum disorders coverage.
§ 3571. Phenylketonuria (PKU) and other inherited metabolic diseases.
§ 3571A. Hearing aid coverage.
§ 3571B. Required coverage for scalp hair prosthesis.
§ 3571C. Dental services for children with a severe disability.
§ 3571D. Screening of infants and toddlers for developmental delays.
§ 3571E. Reimbursement for orthotic and prosthetic services.
§ 3571G. School-based health centers.
§ 3571H. Payment for emergency medical services.
§ 3571P. Rating factors [For application of this section, see 79 Del. Laws, c. 99, § 19].
§ 3571R. Telehealth and telemedicine.
§ 3571S. Network disclosure and transparency.
§ 3571U. Mental Health Parity and Addiction Equity Act reporting requirements.
§ 3571V. Time of submitting claim for reimbursement.
§ 3571W. Electronic medical claims.
§ 3571X. Medication assisted treatment for drug and alcohol dependencies.
§ 3571Y. Coverage for epinephrine autoinjectors.
§ 3571Z. Annual behavioral health well check [Effective Jan. 1, 2024].