Ohio § 3902.61 Advanced cancer fail first drug coverage prohibitions

Ohio Statutes

§ 3902.61 — Advanced cancer fail first drug coverage prohibitions

Ohio § 3902.61

Title 39Insurance

Ch. 3902Insurance Policies And Contracts

This text of Ohio § 3902.61 (Advanced cancer fail first drug coverage prohibitions) is published on Counsel Stack Legal Research, covering Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ohio Rev. Code Ann. § 3902.61 (2026).

Text

(A)Notwithstanding section3901.71and sections3901.831to3901.833of the Revised Code, a health benefit plan issued, delivered, or renewed in this state on or after the effective date of this section that directly or indirectly covers the treatment of stage four advanced metastatic cancer shall not make coverage of a drug that is prescribed to treat such cancer or associated conditions dependent upon a covered person demonstrating either of the following:

(1)Failure to successfully respond to a different drug;

(2)A history of failing to respond to a different drug or drugs.

(B)Division (A) of this section applies only to uses of such drug or drugs that are consistent with either of the following:

(1)An indication approved by, or described in, as applicable, either of the following fo

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(A) Notwithstanding section3901.71and sections3901.831to3901.833of the Revised Code, a health benefit plan issued, delivered, or renewed in this state on or after the effective date of this section that directly or indirectly covers the treatment of stage four advanced metastatic cancer shall not make coverage of a drug that is prescribed to treat such cancer or associated conditions dependent upon a covered person demonstrating either of the following:

(1) Failure to successfully respond to a different drug;

(2) A history of failing to respond to a different drug or drugs.

(B) Division (A) of this section applies only to uses of such drug or drugs that are consistent with either of the following:

(1) An indication approved by, or described in, as applicable, either of the following for the treatment of stage four advanced metastatic cancer:

(a) The United States food and drug administration;

(b) The national comprehensive cancer network drugs and biologics compendium.

(2) The best practices for the treatment of stage four advanced metastatic cancer, as supported by peer-reviewed medical literature.

(C) A violation of this section is an unfair and deceptive practice in the business of insurance under sections3901.19to3901.26of the Revised Code.