2019 Connecticut General Statutes
Title 38a - Insurance
Chapter 700c - Health Insurance
Section 38a-510c - Coverage for investigational drug, biological product or device for insureds with terminal illnesses. Liability of health carrier.
(a) As used in this section, “health carrier” means an insurance company, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues a health insurance policy providing coverage of the type provided in subdivisions (1), (2), (4), (11), (12) and (16) of section 38a-469 in this state.
(b) A health carrier may provide coverage for an investigational drug, biological product or device, as defined in section 20-14q, that is made available pursuant to section 21a-70g to an insured patient who is eligible under subsection (b) of section 20-14q.
(c) A health carrier may deny coverage to an insured patient from the time such patient begins treatment with the investigational drug, biological product or device for a period not to exceed six months from the date such patient ceases treatment with the investigational drug, biological product or device, except that coverage may not be denied for a preexisting condition or for coverage for benefits that commenced prior to the date such patient begins such treatment.
(d) Nothing in this section shall affect the provisions of sections 38a-504a to 38a-504g, inclusive, and 38a-542a to 38a-542g, inclusive, concerning insurance coverage for certain costs associated with clinical trials. Treatment with an investigational drug, biological product or device shall be deemed to constitute the practice of medicine and shall not be considered a clinical trial for the purposes of said sections.
(e) Nothing in this section shall create a cause of action against a health carrier that provides coverage for an investigational drug, biological product or device pursuant to subsection (b) of this section, or denies coverage in accordance with subsection (c) of this section, to an insured patient who begins treatment with an investigational drug, biological product or device.
(P.A. 16-214, S. 3.)
