HOUSE BILL No. 4454

 

March 16, 2011, Introduced by Rep. Genetski and referred to the Committee on Health Policy.

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

by amending section 3406q (MCL 500.3406q), as amended by 2003 PA

 

88.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3406q. (1) An expense-incurred hospital, medical, or

 

surgical policy or certificate delivered, issued for delivery, or

 

renewed in this state that provides pharmaceutical coverage and a

 

health maintenance organization contract that provides

 

pharmaceutical coverage shall provide coverage for an off-label use

 

of a federal food and drug administration approved drug and the

 

reasonable cost of supplies medically necessary to administer the

 

drug.

 

     (2) Coverage for a drug under subsection (1) applies if all of

 

the following conditions are met:

 


     (a) The drug is approved by the federal food and drug

 

administration.

 

     (b) The drug is prescribed by an allopathic or osteopathic

 

physician for the treatment of either of the following:

 

     (i) A life-threatening condition so long as the drug is

 

medically necessary to treat that condition and the drug is on the

 

plan formulary or accessible through the health plan's formulary

 

procedures.

 

     (ii) A chronic and seriously debilitating condition so long as

 

the drug is medically necessary to treat that condition and the

 

drug is on the plan formulary or accessible through the health

 

plan's formulary procedures.

 

     (c) The drug has been recognized for treatment for the

 

condition for which it is prescribed by 1 of the following:

 

     (i) The American medical association drug evaluations.

 

     (ii) The American hospital formulary service drug information.

 

     (iii) The United States pharmacopoeia dispensing information,

 

volume 1, "drug information for the health care professional".

 

     (i) (iv) Two Except as otherwise provided in subparagraph (ii), 2

 

articles from major peer-reviewed medical journals that present

 

data supporting the proposed off-label use or uses as generally

 

safe and effective unless there is clear and convincing

 

contradictory evidence presented in a major peer-reviewed medical

 

journal.

 

     (ii) For cancer treatment, 2 articles from major peer-reviewed

 

medical journals recognized by the centers for medicare and

 

medicaid services that present data supporting the proposed off-

 


label use or uses as generally safe and effective unless there is

 

clear and convincing contradictory evidence presented in a major

 

peer-reviewed medical journal.

 

     (iii) The American hospital formulary service drug information.

 

     (iv) National comprehensive cancer network drugs and biologics

 

compendium.

 

     (v) Thomson Reuters micromedex drugdex.

 

     (vi) Clinical pharmacology.

 

     (vii) Other authoritative compendia as identified by the

 

secretary of the United States department of health and human

 

services and as certified by the commissioner.

 

     (3) Upon request, the prescribing allopathic or osteopathic

 

physician shall supply to the insurer or health maintenance

 

organization documentation supporting compliance with subsection

 

(2).

 

     (4) This section does not prohibit the use of a copayment,

 

deductible, sanction, or a mechanism for appropriately controlling

 

the utilization of a drug that is prescribed for a use different

 

from the use for which the drug has been approved by the federal

 

food and drug administration. This may include prior approval or a

 

drug utilization review program. Any copayment, deductible,

 

sanction, prior approval, drug utilization review program, or

 

mechanism described in this subsection shall not be more

 

restrictive than for prescription coverage generally.

 

     (5) As used in this section:

 

     (a) "Chronic and seriously debilitating" means a disease or

 

condition that requires ongoing treatment to maintain remission or

 


prevent deterioration and that causes significant long-term

 

morbidity.

 

     (b) "Life-threatening" means a disease or condition where the

 

likelihood of death is high unless the course of the disease is

 

interrupted or that has a potentially fatal outcome where the end

 

point of clinical intervention is survival.

 

     (c) "Off-label" means the use of a drug for clinical

 

indications other than those stated in the labeling approved by the

 

federal food and drug administration.