Section 41-6504 – LIMITATIONS ON COVERAGE.
41-6504. LIMITATIONS ON COVERAGE. The issuer of a health benefit plan is not required to provide benefits for routine patient care services provided outside: (1) Of the plan’s health care provider network, unless out-of-network benefits are otherwise provided under the plan; or (2) This state, unless the health benefit plan otherwise provides benefits for health […]
Section 41-6505 – INSURER LIABILITY.
41-6505. INSURER LIABILITY. An insurer that provides coverage required by this chapter is not, based on that coverage, liable for any adverse effects of the approved clinical trial. History: [41-6505, added 2019, ch. 192, sec. 1, p. 605.]
Section 41-6506 – DEDUCTIBLE, COINSURANCE, AND COPAYMENT REQUIREMENTS.
41-6506. DEDUCTIBLE, COINSURANCE, AND COPAYMENT REQUIREMENTS. Benefits may be made subject to a deductible, coinsurance, or copayment requirement comparable to other deductible, coinsurance, or copayment requirements applicable under the health benefit plan. History: [41-6506, added 2019, ch. 192, sec. 1, p. 605.]
Section 41-6507 – CANCELLATION OR NONRENEWAL PROHIBITED.
41-6507. CANCELLATION OR NONRENEWAL PROHIBITED. The issuer of a health benefit plan may not cancel or refuse to renew coverage under a plan solely because an enrollee in the plan participates in a clinical trial. History: [41-6507, added 2019, ch. 192, sec. 1, p. 605.]
Section 41-6501 – “ROUTINE PATIENT CARE COSTS” DEFINED.
41-6501. "ROUTINE PATIENT CARE COSTS" DEFINED. "Routine patient care costs" means the costs of any medically necessary health care service for which benefits are provided under a health benefit plan, without regard to whether the enrollee is participating in a clinical trial. Routine patient care costs do not include the cost: (1) Of an investigational […]
Section 41-6502 – REQUIRED COVERAGE.
41-6502. REQUIRED COVERAGE. The issuer of a health benefit plan shall provide benefits for routine patient care costs to an enrollee in connection with an approved clinical trial. For purposes of this chapter, "approved clinical trial" means a phase I, phase II, phase III, or phase IV clinical trial that is conducted in relation to […]
Section 41-6503 – RESEARCH INSTITUTIONS.
41-6503. RESEARCH INSTITUTIONS. The issuer of a health benefit plan is not required to: (1) Reimburse a research institution conducting a clinical trial for the cost of routine patient care provided through the research institution unless the research institution, and each health care professional providing routine patient care through the research institution, agrees to accept […]