Effective: March 24, 2021
Latest Legislation: Senate Bill 252 - 133rd General Assembly
(A) Notwithstanding section 3901.71 and sections 3901.831 to 3901.833 of the Revised Code, a health benefit plan issued, delivered, or renewed in this state on or after the effective date of this section that directly or indirectly covers the treatment of stage four advanced metastatic cancer shall not make coverage of a drug that is prescribed to treat such cancer or associated conditions dependent upon a covered person demonstrating either of the following:
(1) Failure to successfully respond to a different drug;
(2) A history of failing to respond to a different drug or drugs.
(B) Division (A) of this section applies only to uses of such drug or drugs that are consistent with either of the following:
(1) An indication approved by, or described in, as applicable, either of the following for the treatment of stage four advanced metastatic cancer:
(a) The United States food and drug administration;
(b) The national comprehensive cancer network drugs and biologics compendium.
(2) The best practices for the treatment of stage four advanced metastatic cancer, as supported by peer-reviewed medical literature.
(C) A violation of this section is an unfair and deceptive practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code.
Structure Ohio Revised Code
Chapter 3902 | Insurance Policies and Contracts
Section 3902.01 | Purpose of Sections.
Section 3902.02 | Insurance Policy and Contract Definitions.
Section 3902.03 | Policies to Which Sections Apply - Exceptions - Non-English Language Policies.
Section 3902.04 | Requirements for Policy Forms.
Section 3902.05 | Construction.
Section 3902.06 | Superintendent May Authorize Lower Test Score.
Section 3902.07 | Approval of Policy Form Notwithstanding Provisions of Other Laws.
Section 3902.08 | Policy Forms Compliance Date.
Section 3902.11 | Coordination of Benefits Definitions.
Section 3902.12 | Primary or Secondary Health Coverage.
Section 3902.13 | Order of Benefits for Health Coverage Plan.
Section 3902.21 | Standard Claim Form Definitions.
Section 3902.22 | Superintendent to Develop Standard Claim Form.
Section 3902.23 | Use of Form Mandatory.
Section 3902.30 | Coverage for Telehealth Services.
Section 3902.31 | Void Contracts.
Section 3902.36 | Compliance With Federal Mental Health and Addiction Parity Laws.
Section 3902.50 | Definitions for r.c. 3902.50 to 3902.72.
Section 3902.51 | Out-of-Network Care Reimbursement Requirement, Negotiations.
Section 3902.52 | Out-of-Network Care Arbitration.
Section 3902.53 | Out-of-Network Care Rules, Prompt Pay Requirements, Violations.
Section 3902.54 | Out-of-Network Care Arbitrator Requirements.
Section 3902.60 | Advanced Cancer Fail First Drug Coverage Definitions.
Section 3902.61 | Advanced Cancer Fail First Drug Coverage Prohibitions.
Section 3902.62 | Coverage for Drugs Refilled Without a Prescription.
Section 3902.70 | Health Plan Issuer Contracts With 340b Program Participants Definitions.
Section 3902.71 | Health Plan Issuer Contracts With 340b Program Participants.
Section 3902.72 | Health Plan Issuer Disclosure of Drug Data.