Fla. Stat. 627.4239
Coverage for use of drugs in treatment of cancer


(1)

DEFINITIONS.As used in this section, the term:“Medical literature” means scientific studies published in a United States peer-reviewed national professional journal.“Standard reference compendium” means authoritative compendia identified by the Secretary of the United States Department of Health and Human Services and recognized by the federal Centers for Medicare and Medicaid Services.

(a)

“Medical literature” means scientific studies published in a United States peer-reviewed national professional journal.

(b)

“Standard reference compendium” means authoritative compendia identified by the Secretary of the United States Department of Health and Human Services and recognized by the federal Centers for Medicare and Medicaid Services.

(2)

COVERAGE FOR TREATMENT OF CANCER.An insurer may not exclude coverage in any individual or group insurance policy issued, amended, delivered, or renewed in this state which covers the treatment of cancer for any drug prescribed for the treatment of cancer on the ground that the drug is not approved by the United States Food and Drug Administration for a particular indication, if that drug is recognized for treatment of that indication in a standard reference compendium or recommended in the medical literature.Coverage for a drug required by this section also includes the medically necessary services associated with the administration of the drug.

(a)

An insurer may not exclude coverage in any individual or group insurance policy issued, amended, delivered, or renewed in this state which covers the treatment of cancer for any drug prescribed for the treatment of cancer on the ground that the drug is not approved by the United States Food and Drug Administration for a particular indication, if that drug is recognized for treatment of that indication in a standard reference compendium or recommended in the medical literature.

(b)

Coverage for a drug required by this section also includes the medically necessary services associated with the administration of the drug.

(3)

APPLICABILITY AND SCOPE.This section may not be construed to:Alter any other law with regard to provisions limiting coverage for drugs that are not approved by the United States Food and Drug Administration.Require coverage for any drug if the United States Food and Drug Administration has determined that the use of the drug is contraindicated.Require coverage for a drug that is not otherwise approved for any indication by the United States Food and Drug Administration.Affect the determination as to whether particular levels, dosages, or usage of a medication associated with bone marrow transplant procedures are covered under an individual or group health insurance policy or health maintenance organization contract.Apply to specified disease or supplemental policies.

(a)

Alter any other law with regard to provisions limiting coverage for drugs that are not approved by the United States Food and Drug Administration.

(b)

Require coverage for any drug if the United States Food and Drug Administration has determined that the use of the drug is contraindicated.

(c)

Require coverage for a drug that is not otherwise approved for any indication by the United States Food and Drug Administration.

(d)

Affect the determination as to whether particular levels, dosages, or usage of a medication associated with bone marrow transplant procedures are covered under an individual or group health insurance policy or health maintenance organization contract.

(e)

Apply to specified disease or supplemental policies.

(4)

Nothing in this section is intended, expressly or by implication, to create, impair, alter, limit, modify, enlarge, abrogate, prohibit, or withdraw any authority to provide reimbursement for drugs used in the treatment of any other disease or condition.

Source: Section 627.4239 — Coverage for use of drugs in treatment of cancer, https://www.­flsenate.­gov/Laws/Statutes/2024/0627.­4239 (accessed Aug. 7, 2025).

627.401
Scope of this part
627.402
Definitions
627.403
“Premium” defined
627.404
Insurable interest
627.405
Insurable interest
627.406
Power to contract
627.407
Alteration of application
627.408
Application as evidence
627.409
Representations in applications
627.410
Filing, approval of forms
627.411
Grounds for disapproval
627.412
Standard provisions, in general
627.413
Contents of policies, in general
627.414
Additional policy contents
627.415
Charter, bylaw provisions
627.416
Execution of policies
627.417
Underwriters’ and combination policies
627.418
Validity of noncomplying contracts
627.419
Construction of policies
627.420
Binders
627.421
Delivery of policy
627.422
Assignment of policies or post-loss benefits
627.423
Payment discharges insurer
627.424
Minor may give acquittance
627.425
Forms for proof of loss to be furnished
627.426
Claims administration
627.427
Payment of judgment by insurer
627.429
Medical tests for HIV infection and AIDS for insurance purposes
627.441
Commercial general liability policies
627.442
Insurance contracts
627.443
Essential health benefits
627.444
Loss run statements for all lines of insurance
627.445
Paid family leave insurance
627.446
Advanced explanation of benefits
627.4025
Residential coverage and hurricane coverage defined
627.4035
Payment of premiums
627.4085
Insurer name, agent name, and license identification number required on application
627.4091
Specific reasons for denial, cancellation, or nonrenewal
627.4101
Credit insurance enrollment forms
627.4102
Informational filing of forms
627.4105
Life and health insurance
627.4107
Government employees exposed to toxic drug chemicals
627.4108
Claims-handling manuals
627.4131
Telephone number required
627.4132
Stacking of coverages prohibited
627.4133
Notice of cancellation, nonrenewal, or renewal premium
627.4135
Casualty insurance contracts subject to general provisions for insurance contracts
627.4136
Nonjoinder of insurers
627.4137
Disclosure of certain information required
627.4138
Wrap-up insurance policies for nonpublic construction projects
627.4143
Outline of coverage
627.4145
Readable language in insurance policies
627.4147
Medical malpractice insurance contracts
627.4148
Medical malpractice insurers
627.4195
Health insurance
627.4205
Coverage identification number required
627.4215
Disclosures to policyholders
627.4232
Health insurance out-of-hospital benefits
627.4233
Total disability defined
627.4234
Health insurance cost containment provisions required
627.4235
Coordination of benefits
627.4236
Coverage for bone marrow transplant procedures
627.4237
Sickness disability or disability due to sickness
627.4238
Health insurer examinations
627.4239
Coverage for use of drugs in treatment of cancer
627.4265
Payment of settlement
627.4295
Dental procedures
627.4301
Genetic information for insurance purposes
627.4302
Identification cards for processing prescription drug claims
627.40951
Standard personal lines residential insurance policy
627.40952
Savings reflections in residential property and motor vehicle insurer rate filings related to specified chapter laws
627.41495
Public notice of medical malpractice rate filings
627.42391
Insurance policies
627.42392
Prior authorization
627.42393
Step-therapy protocol
627.42395
Coverage for certain prescription and nonprescription enteral formulas
627.42396
Reimbursement for telehealth services
627.42397
Coverage for air ambulance services
627.43141
Notice of change in policy terms

Current through Fall 2025

§ 627.4239. Coverage for use of drugs in treatment of cancer's source at flsenate​.gov