Health Insurance:
Coverage & Navigation

This chart highlights the state laws related to health insurance coverage and navigation, including oral chemotherapy, step therapy, clinical trials, second opinions, and more. Check back often, as these charts are updated frequently.

If you have a self-funded plan, certain state laws may not apply. For information on how to determine if your plan is self-funded, see our blog post.

For more health insurance information, visit our Health Insurance Materials & Resources.

StateOral Chemotherapy Parity Law*Clinical Trials Coverage LawLaws Limiting Surprise BillingWho Runs External Appeals ProcessCoverage of Second Medical OpinionsDistinguishes Out-of-Network Second Opinions
ALABAMARun by HHShttps://externalappeal.cms.gov/ferpportal/
ALASKA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.akleg.gov/basis/Bill/Text/29?Hsid=SB0142ZRequires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://law.justia.com/codes/alaska/2022/title-21/chapter-42/article-2/section-21-42-415/Run by State Agencyhttps://www.commerce.alaska.gov/web/ins/Consumers/Health/ExternalHealthcareReview.aspx
ARIZONA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.azleg.gov/legtext/51leg/2r/laws/0255.pdfRequires insurers to cover certain patient costs from approved clinical trials related to cancer.https://apps.azleg.gov/BillStatus/GetDocumentPdf/59648All carehttps://apps.azleg.gov/BillStatus/GetDocumentPdf/453367Run by State Agencyhttps://difi.az.gov/sites/default/files/Consumer_Guide_to_Health_Care_Appeals_202110.pdf
ARKANSAS
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
http://www.arkleg.state.ar.us/assembly/2017/2017R/Bills/HB1592.pdfRun by State Agencyhttps://www.insurance.arkansas.gov/site/assets/files/2007/er_faq.pdf
CALIFORNIA
Caps out-of-pocket costs at $250 for a 30-day supply of oral chemo.
https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=INS&division=2.&title=&part=2.&chapter=1.&article=1.Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.http://www.leginfo.ca.gov/pub/01-02/bill/sen/sb_0001-0050/sb_37_bill_20010810_chaptered.htmlAll carehttps://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB72Run by State Agencyhttps://www.insurance.ca.gov/01-consumers/101-help/Independent-Medical-Review-Program.cfmOnly applies to disability insurers covering hospital, medical, or surgical expenses. Insurers describe what constitutes as necessary & appropriate for second medical opinion.https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=INS§ionNum=10123.67.Yes, Must cover outside network second opinion if there's no participating in-network providers that meet standards
COLORADO
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://legiscan.com/CO/text/HB1202/2010Requires insurers to cover routine patient care costs from clinical trials recommended by a treating physician.https://codes.findlaw.com/co/title-10-insurance/co-rev-st-sect-10-16-104/All carehttp://leg.colorado.gov/sites/default/files/2019a_1174_signed.pdfRun by State Agencyhttps://drive.google.com/file/d/0BwguXutc4vbpMlZYWkxjWll2TGM/viewDoes not explicitly require insurance companies to provide coverage, but requires clear and complete statement if it does allow for second opinion.https://casetext.com/statute/colorado-revised-statutes/title-10-insurance/health-care-coverage/article-16-health-care-coverage/part-7-consumer-protection-standards-act-for-the-operation-of-managed-care-plans/section-10-16-705-requirements-for-carriers-and-participating-providers-definitions
CONNECTICUT
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/connecticut/2012/title-38a/chapter-700c/section-38a-504Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://www.cga.ct.gov/2001/act/Pa/2001PA-00171-R00SB-00325-PA.htmAll carehttps://www.cga.ct.gov/current/pub/chap_700c.htmRun by State Agencyhttps://portal.ct.gov/cid/-/media/CID/1_ConsumerResources/External-Review-Program-FAQs.pdf
DELAWARE
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://delcode.delaware.gov/title18/c033/sc01/index.shtmlRequires insurers to cover routine patient care costs from approved clinical trials related to life threatening diseases.https://legis.delaware.gov/BillDetail/11875All carehttps://legis.delaware.gov/SessionLaws/Chapter?id=19067Run by State Agencyhttps://insurance.delaware.gov/divisions/consumerhp/ihcap/
*DISTRICT OF COLUMBIA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://code.dccouncil.gov/us/dc/council/code/sections/31-2995.02Requires insurers to cover routine patient care costs from approved clinical trials.https://code.dccouncil.gov/us/dc/council/code/sections/31-2993.02Run by State Agencyhttps://dhcf.dc.gov/publication/grievancesappeals-0
FLORIDA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
http://www.flsenate.gov/Session/Bill/2013/301/BillText/c1/PDFAll carehttp://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0600-0699/0627/Sections/0627.64194.htmlRun by HHShttps://externalappeal.cms.gov/ferpportal/Right to second medical opinion in instances where subscriber disputes organization/physician's opinion of reasonbleness or necessity.http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0600-0699/0641/Sections/0641.51.htmlOrganizations need to develop and maintain policy to determine when exceptional referrals to out-of-network specially qualified providers . . . All financial arrangements shall be agreed to prior to services being rendered
GEORGIA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/georgia/2022/title-33/chapter-24/article-1/section-33-24-56-5/Requires clinical trial sponsors to provide potential patients with information around costs at the time of informed consenthttps://legiscan.com/GA/text/SB223/2023All carehttps://rules.sos.ga.gov/gac/120-2-106Run by HHShttps://externalappeal.cms.gov/ferpportal/
HAWAII
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/hawaii/2013/title-24/chapter-432/section-432-1-616/Run by State Agencyhttps://cca.hawaii.gov/ins/external-review-of-health-plan-disputes/
IDAHORequires insurers to cover routine patient care costs from approved clinical trials.https://legislature.idaho.gov/statutesrules/idstat/title41/t41ch65/sect41-6502/Run by State Agencyhttps://doi.idaho.gov/consumers/health-insurance/external-review/
ILLINOIS
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo, with no additional treatment restrictions.
https://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=021500050HArt.+XXII&ActID=1249&ChapAct=215%C2%A0ILCS%C2%A05%2F&ChapterID=22&ChapterName=INSURANCE&SectionID=52304&SeqStart=107000000&SeqEnd=108700000&ActName=IRequires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=021500050K364.01All carehttp://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=096-1523Run by State Agencyhttps://idoi.illinois.gov/consumers/file-an-external-review.htmlBenefit Plans under minimum benefits include second surgical opinions.https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1254&ChapterID=22
INDIANA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/indiana/2022/title-27/article-13/chapter-7/section-27-13-7-20/Requires insurers to cover routine patient care costs from clinical trials.https://casetext.com/statute/indiana-code/title-27-insurance/article-8-life-accident-and-health/chapter-25-coverage-for-care-related-to-clinical-trials/section-27-8-25-8-coverage-for-routine-care-costsAll care (except ER)http://iga.in.gov/legislative/2020/bills/house/1004Run by State Agencyhttps://www.in.gov/idoi/3008.htmHMO enrollees may obtain second medical opinions from appropriate participating providers.http://iga.in.gov/legislative/laws/2020/ic/titles/027#27-13-37-5
IOWA
Requires insurers to provide the same coverage benefits for oral chemo as those for intravenous chemo.
https://www.legis.iowa.gov/docs/code/514C.24.pdfRequires insurers to cover routine patient care costs from approved clinical trials related to cancer that are recommended by two physicians.https://www.legis.iowa.gov/docs/code/514C.26.pdfER onlyhttps://www.legis.iowa.gov/docs/code/514C.16.pdfRun by State Agencyhttps://iid.iowa.gov/external-review
KANSAS
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.ksrevisor.org/statutes/chapters/ch40/040_002_0184.htmlRequires insurers to cover routine patient care costs from clinical trials related to cancer that are recommended by a treating physician.https://casetext.com/regulation/kansas-administrative-code/agency-40-insurance-department/article-4-accident-and-health-insurance/section-40-4-43-hospital-medical-and-surgical-expense-insurance-policies-and-certificates-prohibiting-certain-types-of-discriminationRun by State Agencyhttps://insurance.ks.gov/documents/department/publications/independent-medical-review.pdf
KENTUCKY
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.lawserver.com/law/state/kentucky/ky-statutes/kentucky_statutes_304-17a-172Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45840Run by State Agencyhttp://insurance.ky.gov/ppc/Documents/abdappeal071217.pdfRequires an insurer to cover cost of second opinion of participating health care providerhttps://apps.legislature.ky.gov/law/statutes/statute.aspx?id=17430
LOUISIANA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/louisiana/2022/revised-statutes/title-22/rs-22-999-1/Requires insurers to cover patient care costs from approved clinical trials related to cancer.https://law.justia.com/codes/louisiana/2022/revised-statutes/title-22/rs-22-1044/Run by State Agencyhttps://www.ldi.la.gov/docs/default-source/documents/publicaffairs/consumerpublications/understanding-your-healthcare-rights.pdf?sfvrsn=45277652_22
MAINE
Requires insurers to provide coverage for oral chemo that is equivalent to that for intravenous chemo.
http://www.mainelegislature.org/legis/bills/bills_126th/chapters/PUBLIC449.aspRequires insurers to cover routine patient care costs from approved clinical trials related to a life-threatening illness and recommended by a treating physician.http://www.mainelegislature.org/legis/statutes/24-A/title24-Ach56-A.pdfAll carehttp://legislature.maine.gov/legis/bills/bills_129th/billtexts/HP150101.aspRun by State Agencyhttps://www.maine.gov/pfr/insurance/consumers/long-term-care-insurance/complaints-appeals
MARYLAND
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/maryland/2022/insurance/title-15/subtitle-8/section-15-846/Requires insurers to cover patient care costs from approved clinical trials related to cancer.https://law.justia.com/codes/maryland/2022/insurance/title-15/subtitle-8/section-15-827/All carehttp://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=19-710&enactments=falseRun by State Agencyhttps://insurance.maryland.gov/Consumer/Pages/AppealsAndGrievances.aspx
MASSACHUSETTS
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://malegislature.gov/Laws/GeneralLaws/PartI/TitleIV/Chapter32A/Section17KRequires insurers to cover patient care costs from approved clinical trials related to cancer.https://malegislature.gov/Laws/SessionLaws/Acts/2002/Chapter257All carehttps://www.mass.gov/files/documents/2018/03/14/2015-ctr-out-of-network.pdfRun by State Agencyhttps://www.mass.gov/request-an-external-review-of-a-health-insurance-decision
MICHIGAN
Requires insurers to either cover oral chemo at a rate no higher than that for intravenous chemo or cap out-of-pocket expenses at $250 for a 30-day supply of oral chemo.
http://www.legislature.mi.gov/documents/2023-2024/publicact/pdf/2023-PA-0170.pdfAll carehttps://www.legislature.mi.gov/(S(htpfz3t3z35rmjkrhaqvdm1t))/mileg.aspx?page=getObject&objectName=mcl-368-1978-18Run by State Agencyhttps://difs.state.mi.us/Complaints/ExternalReview.aspx
MINNESOTA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.revisor.mn.gov/statutes/cite/62A.3075Requires insurers to cover routine patient care costs from clinical trials related to cancer and recommended by a treating physician.https://www.revisor.mn.gov/statutes/cite/62Q.526All carehttps://www.revisor.mn.gov/statutes/cite/62Q.556Run by State Agencyhttp://mn.gov/commerce-stat/pdfs/external-review-appeal.pdfSecond opinions needed in all minimum benefits health plans for surgeries exceeding $500, HMO enrollees eligibe in cases of chemical dependency and mental healthhttps://www.revisor.mn.gov/statutes/cite/62E.06 https://www.revisor.mn.gov/statutes/cite/62D.103
MISSISSIPPI
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://legiscan.com/MS/text/HB952/2015All carehttps://legiscan.com/MS/text/HB374/id/734015/Mississippi-2013-HB374-Enrolled.htmlRun by State Agencyhttps://www.mid.ms.gov/healthcare/external-review.aspx
MISSOURI
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo or cap out-of-pocket expenses at $75 for a 30-day supply of oral chemo.
https://legiscan.com/MO/text/SB668/id/983931Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.http://www.senate.mo.gov/06info/pdf-bill/tat/SB567.pdfER onlyhttps://revisor.mo.gov/main/OneSection.aspx?section=376.690Run by State Agencyhttps://insurance.mo.gov/consumers/health/externalreviewprocess.phpAllows enrollees to seek second medical opinion at no additional costhttps://revisor.mo.gov/main/OneSection.aspx?section=354.207&bid=19039&hl=
MONTANARequires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://legiscan.com/MT/text/SB55/2013ER onlyhttps://leg.mt.gov/bills/mca/title_0330/chapter_0020/part_0230/section_0020/0330-0020-0230-0020.htmlRun by State Agencyhttps://benefits.mt.gov/enrollment-and-claims/appealing-unreimbursed-claims
NEBRASKA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/nebraska/2022/chapter-44/statute-44-7-104/ER onlyhttps://custom.statenet.com/public/resources.cgi?id=ID:bill:NE2019000L997&cuiq=05748d3c-33bd-57a1-9a02-5f138328b4b9&client_md=7384d79ae7f15dfb68295a6cdef5e66e&mode=current_textRun by State Agencyhttps://doi.nebraska.gov/sites/doi.nebraska.gov/files/doc/out13261.pdf
NEVADA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo and cap out-of-pocket expenses at $100 per oral chemo prescription.
https://legiscan.com/NV/text/SB266/2013Requires insurers to cover patient care costs from approved clinical trials related to cancer.https://www.leg.state.nv.us/73rd/bills/SB/SB29.pdfER onlyhttps://www.leg.state.nv.us/nrs/nrs-439B.html#NRS439BSec745Run by State Agencyhttps://adsd.nv.gov/Programs/CHA/ExtRev/External_Review/
NEW HAMPSHIRE
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://legiscan.com/NH/text/HB508/2015Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.http://www.gencourt.state.nh.us/legislation/2000/sb0409.htmlAll carehttps://www.gencourt.state.nh.us/rsa/html/XXX/329/329-31-b.htmRun by State Agencyhttps://www.nh.gov/insurance/consumers/appeals.htmEmployer's insurance carrier or self-insurer provides an employee with reasonable access to second medical opinion, inside or outside the programhttps://www.gencourt.state.nh.us/rsa/html/XXIII/281-A/281-A-23-a.htm
NEW JERSEY
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/new-jersey/2022/title-17/section-17-48-6jj/Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://academic.oup.com/jnci/article/92/4/300/2624693All carehttps://www.state.nj.us/dobi/division_consumers/insurance/outofnetwork.htmlRun by State Agencyhttps://www.state.nj.us/dobi/division_consumers/insurance/appealcomplaintguide.pdfIn addition to second opinion, statute requires insurance program to cover third surgical opinions if second opinion does not confirm medical advisability. Applies to surgery second/third opinions.https://casetext.com/statute/new-jersey-statutes/title-17-corporations-and-institutions-for-finance-and-insurance/chapter-1748e/section-1748e-33-second-third-surgical-opinions
NEW MEXICO
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/new-mexico/2021/chapter-59a/article-23/section-59a-23-7-10/Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://law.justia.com/codes/new-mexico/2021/chapter-59a/article-22/section-59a-22-43/All carehttps://www.nmlegis.gov/Sessions/19 Regular/final/SB0337.pdfRun by State Agencyhttps://www.osi.state.nm.us/pages/bureaus/mhcb/resources/consumer-guide-to-filing-an-appeal
NEW YORK
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/new-york/2022/isc/article-32/3221/All carehttps://www.nysenate.gov/legislation/laws/FIS/A6Run by State Agencyhttps://www.dfs.ny.gov/complaints/file_external_appealRequires contracts for covered services to provide coverage for second medical opinion.https://www.nysenate.gov/legislation/laws/ISC/4303 https://www.nysenate.gov/legislation/laws/ISC/3216Yes, In the case of a contract that requires, or provides financial incentives for, the covered person to receive covered services from health care providers participating in a provider network maintained by or under contract with the corporation, the contract shall include coverage for a second medical opinion from a non-participating specialist, including but not limited to a specialist affiliated with a specialty care center for the treatment of cancer, when the attending physician provides a written referral to a non-participating specialist, at no additional cost to the covered person beyond what such covered person would have paid for services from a participating appropriate specialist.
NORTH CAROLINARequires insurers to cover patient care costs from approved Phase II, III and IV clinical trials related to life-threatening medical conditions.https://www.ncleg.net/Sessions/2001/Bills/Senate/HTML/S199v5.htmlER onlyhttps://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_58/Article_3.htmlRun by State Agencyhttps://www.ncdoi.gov/consumers/health-insurance/health-claim-denied/request-external-review
NORTH DAKOTA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.legis.nd.gov/assembly/63-2013/interim/15-0117-04000.pdfRun by State Agencyhttps://www.nd.gov/ndins/health
OHIO
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo or cap out-of-pocket expenses at $100 per oral chemo prescription.
https://codes.ohio.gov/ohio-revised-code/section-3923.85Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://codes.ohio.gov/ohio-revised-code/section-3923.80All carehttps://search-prod.lis.state.oh.us/solarapi/v1/general_assembly_133/bills/hb388/EN/05/hb388_05_EN?format=pdfRun by State Agencyhttps://insurance.ohio.gov/consumers/health/understanding-health-coverage-external-review-appeal
OKLAHOMA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo or cap out-of-pocket expenses at $100 per oral chemo prescription.
https://oksenate.gov/sites/default/files/2019-12/os36.pdfRun by State Agencyhttps://www.oid.ok.gov/consumers/external-review-process/
OREGON
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://oregon.public.law/statutes/ors_743a.068Requires insurers to cover routine patient care costs from approved clinical trials.https://www.oregonlaws.org/ors/743A.192All carehttps://www.oregonlegislature.gov/bills_laws/ors/ors743b.htmlRun by State Agencyhttps://dfr.oregon.gov/insure/health/understand/coverage/Pages/if-your-claim-was-denied.aspxEnrollee may obtain second medical opinion within network if insurer offers a health plan benefit that requires specialty care serviceshttps://www.oregonlegislature.gov/bills_laws/ors/ors743B.htmlYes, health plans must allow enrolle to obtain opinion or consultation from similarly qualified physician who is not a network provider; plan may not impose charge greater than cost that the enrollee would otherwise pay
PENNSYLVANIA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.legis.state.pa.us/cfdocs/Legis/LI/uconsCheck.cfm?txtType=HTM&yr=2016&sessInd=0&smthLwInd=0&act=0073.ER onlyhttp://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/028/chapter9/subchapHtoc.html&d=reduceRun by HHS https://externalappeal.cms.gov/ferpportal/
*PUERTO RICORun by State Agencyhttp://ocs.gobierno.pr/ocspr/index.php/seguros-de-salud/370
RHODE ISLAND
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
http://webserver.rilin.state.ri.us/Statutes/title27/27-18/27-18-80.htmRequires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://law.justia.com/codes/rhode-island/2013/title-27/chapter-27-18/section-27-18-74All carehttp://webserver.rilin.state.ri.us/BillText/BillText18/SenateText18/S2077Aaa.pdfRun by State Agencyhttp://www.eohhs.ri.gov/Consumer/ConsumerInformation/Appeals.aspxInsurance benefits must cover second and third medical opinionshttp://webserver.rilegislature.gov//Statutes/TITLE27/27-39/27-39-2.HTM http://webserver.rilegislature.gov//Statutes/TITLE27/27-39/27-39-3.HTM
SOUTH CAROLINARun by State Agencyhttps://doi.sc.gov/DocumentCenter/View/2554/Patients-Guide-to-External-Review?bidId=
SOUTH DAKOTA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://www.billtrack50.com/billdetail/565089Run by State Agencyhttps://dlr.sd.gov/insurance/external_review_health_major_medical.aspx
TENNESSEERequires insurers to cover routine patient care costs from approved clinical trials related to cancer that are recommended by a treating physician.http://www.capitol.tn.gov/Bills/104/Bill/HB0837.pdfRun by State Agencyhttps://www.tn.gov/commerce/tenncare-oversight/mco-dispute-resolution/independent-review-process.html
TEXAS
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/texas/2017/insurance-code/title-8/subtitle-e/chapter-1369/Requires insurers to cover routine patient care costs from approved clinical trials related to a life-threatening condition.https://capitol.texas.gov/tlodocs/81R/billtext/html/SB00039F.htmAll carehttps://www.tdi.texas.gov/medical-billing/providers.htmlRun by HHShttps://externalappeal.cms.gov/ferpportal/
UTAH
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://le.utah.gov/~2013/bills/sbillint/sb0189.pdfRun by State Agencyhttps://insurance.utah.gov/consumer/health/independent-review
VERMONT
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://legislature.vermont.gov/statutes/section/08/107/04100hRequires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://legislature.vermont.gov/statutes/section/08/107/04088bER onlyhttps://legislature.vermont.gov/statutes/fullchapter/33/065Run by State Agencyhttps://dfr.vermont.gov/consumers/file-complaint/insurance/healthcare-external-appeal
VIRGINIA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.lis.virginia.gov/vacode/title38.2/chapter34/section38.2-3407.18/Requires insurers to cover patient care costs from approved clinical trials related to cancer.http://leg1.state.va.us/cgi-bin/legp504.exe?991+ful+CHAP0643All carehttps://law.lis.virginia.gov/vacode/title38.2/chapter34/section38.2-3445.01/Run by State Agencyhttps://scc.virginia.gov/pages/External-Review-(1)
WASHINGTON
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://app.leg.wa.gov/rcw/default.aspx?cite=41.05.175Requires insurers to cover routine patient care costs from approved clinical trials related to cancer.https://app.leg.wa.gov/WAC/default.aspx?cite=284-43-5420&pdf=trueAll carehttps://app.leg.wa.gov/RCW/default.aspx?cite=48.49.020Run by State Agencyhttps://www.insurance.wa.gov/appealing-health-insurance-denialHealth service carriers must provide enrolleess access to a second medical opinionhttps://app.leg.wa.gov/RCW/default.aspx?cite=48.43.515
WEST VIRGINIA
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://code.wvlegislature.gov/33-15-4l/Requires insurers to cover patient care costs from approved Phase II, III and IV clinical trials related to cancer.http://www.wvlegislature.gov/Bill_Text_HTML/2003_SESSIONS/rs/BILLS/hb2675%20enr.htmER onlyhttp://www.wvlegislature.gov/WVCODE/code.cfm?chap=33&art=25ARun by State Agencyhttps://www.wvinsurance.gov/portals/0/pdf/External Review Request Form 2-4-2016.pdfManaged care plans must provide accesss to second opinion for enrolleeshttps://code.wvlegislature.gov/33-25C-4/
WISCONSIN
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://docs.legis.wisconsin.gov/2013/related/acts/186Requires insurers to cover patient care costs from approved clinical trials related to cancer.http://docs.legis.wisconsin.gov/2005/related/proposals/ab617.pdfRun by HHShttps://externalappeal.cms.gov/ferpportal/Defined network plans are required to provide coverage for second opinionshttps://docs.legis.wisconsin.gov/statutes/statutes/609/22
WYOMING
Requires insurers to cover oral chemo at a rate no higher than that for intravenous chemo.
https://law.justia.com/codes/wyoming/2022/title-26/chapter-20/article-6/section-26-20-601/Requires insurers to cover routine patient care costs from approved Phase II, III and IV clinical trials related to cancer.https://www.wyoleg.gov/2008/Enroll/SF0024.pdfRun by State Agencyhttps://doi.wyo.gov/consumers/iro
GUAMRun by HHShttps://externalappeal.cms.gov/ferpportal/
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