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<section article="gin" article_name="Insurance" number="15-804" title_number="15" title_name="Health Insurance" subtitle_number="8" subtitle_name="Required Health Insurance Benefits">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Medical literature” means scientific studies published in a peer–reviewed national professional medical journal.</text>
    </level>
    <level label="3">
      <text>“Off–label use” means the prescription of a drug for a treatment other than those treatments stated in the labeling approved by the federal Food and Drug Administration.</text>
    </level>
    <level label="4">
      <text>“Standard reference compendia” means any authoritative compendia as recognized periodically by the federal Secretary of Health and Human Services or the Commissioner.</text>
    </level>
  </level>
  <level label="b">
    <text>This section does not:</text>
    <level label="1">
      <text>alter any law that limits the coverage of drugs that have not been approved by the federal Food and Drug Administration;</text>
    </level>
    <level label="2">
      <text>require coverage of a drug if the federal Food and Drug Administration has determined use of the drug to be contraindicated; or</text>
    </level>
    <level label="3">
      <text>require coverage of experimental drugs not approved for any indication by the federal Food and Drug Administration.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>This subsection applies to each health insurance policy or contract that is delivered or issued for delivery in the State to an employer or individual on a group or individual basis, including a contract issued by a health maintenance organization.</text>
    </level>
    <level label="2">
      <text>A policy or contract subject to this subsection that provides coverage for drugs may not exclude coverage of a drug for an off–label use of the drug if the drug is recognized for treatment in any of the standard reference compendia or in the medical literature.</text>
    </level>
    <level label="3">
      <text>Coverage of a drug required by this subsection also includes medically necessary services associated with the administration of the drug.</text>
    </level>
  </level>
  <level label="d">
    <text>The Commissioner may direct a person, including a health maintenance organization, that issues a health insurance policy or contract to make payments required by this section.</text>
  </level>
</section>
