Volume 796, Page 1675 View pdf image |
(7) (i) "Patient cost" means the cost of a medically necessary health (ii) "Patient cost" does not include: 1. the cost of an investigational drug or device; 2. the cost of nonhealth care services that a patient may be 3. costs associated with managing the research associated 4. costs that would not be covered under the patient's policy, (b) This section applies to: (1) insurers and nonprofit health service plans that provide hospital, (2) health maintenance organizations that provide hospital, medical, (c) This section does not apply to a policy, plan, or contract paid for under Title (d) A policy, plan, or contract subject to this section shall provide coverage for (1) treatment provided for a life-threatening condition; or (2) prevention, early detection, and treatment studies on cancer. (e) The coverage under subsection (d) of this section shall be required if: (1) (i) the treatment is being provided or the studies are being (ii) the treatment is being provided in a PHASE I, Phase II, Phase (2) the treatment is being provided in a clinical trial approved by: (i) one of the National Institutes of Health; (ii) an NIH cooperative group or an NIH center; (iii) the FDA in the form of an investigational new drug application;
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Volume 796, Page 1675 View pdf image |
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