Chemotherapy Benefits

Bulletin 172 October 26, 2009 CHEMOTHERAPY BENEFITS This Bulletin is directed to all insurers issuing or delivering policies ofaccident and sickness insurance in the state oflndiana as defined by IC 27-8-5-1 and all health maintenance organizations (HMOs) specified by IC 27-13-7-20 regarding chemotherapy medications. This Bulletin is intended to provide guidance on the implementation ofIC 27-8-32 and IC 27-13-7-20 for policies issued, renewed or delivered after December 31, 2009. The Department interprets IC 27-8-32 and IC 27-13-7-20 as applicable only to health insurance plans defined pursuant to IC 27-8-14.5-1. Policies of accident & health, including HMO contracts, that provide coverage for both oral and intravenous/injectable chemotherapy treatment shall provide coverage for oral chemotherapy that is no less favorable in terms of dollar limits, copayments, deductibles or coinsurance than the coverage provided pursuant to the non-pharmacy policy benefits for chemotherapy. Questions concerning this bulletin should be addressed to Robyn S. Crosson, Chief Deputy Commissioner for Company Compliance Services, who can be reached at (317) 234­ 6293 or rcrosson@idoi.in.gov. INDIANA DEPARTMENT OF INSURANCE Carol Cutter, Commissioner