(1) No insurance policy or contract providing coverage for a prescription drug to a resident of this state shall exclude coverage of that drug for a particular indication solely on the grounds that the indication has not been approved by the United States Food and Drug Administration if the Health Resources Commission determines that the drug is recognized as effective for the treatment of that indication:
(a) In publications that the commission determines to be equivalent to:
(A) The American Hospital Formulary Services drug information;
(B) “Drug Facts and Comparisons” (Lippincott-Raven Publishers);
(C) The United States Pharmacopoeia drug information; or
(D) Other publications that have been identified by the United States Secretary of Health and Human Services as authoritative;
(b) In the majority of relevant peer-reviewed medical literature; or
(c) By the United States Secretary of Health and Human Services.
(2) Required coverage of a prescription drug under this section shall include coverage for medically necessary services associated with the administration of that drug.
(3) Nothing in this section requires coverage for any prescription drug if the United States Food and Drug Administration has determined use of the drug to be contraindicated.
(4) Nothing in this section requires coverage for experimental drugs not approved for any indication by the United States Food and Drug Administration.
(5) This section is exempt from ORS 743A.001. [Formerly 743.697]
Section: Previous 743A.032 743A.036 743A.040 743A.044 743A.048 743A.050 743A.060 743A.062 743A.064 743A.066 743A.068 743A.070 743A.080 743A.084 743A.088 NextLast modified: August 7, 2008