NCCN recognizes the organizations listed below for their policies related to coverage of quality cancer care.
NCCN would also like to recognize and express appreciation to Hines and Associates for its expertise and assistance in developing and implementing this recognition program. Hines and Associates encourages its clients to support coverage of Routine Costs of Care for those enrolled in an Approved Cancer clinical trial and off-label use of oncology-related drugs by using NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) as the basis for coverage decisions.
Payor organizations are those that establish and apply coverage policies.
The payor organizations listed below have attested that their policy is to cover off-label use of drugs and biologics for cancer treatment that are indicated in the version of the NCCN Compendium® in place at the time of treatment with Category 1, 2A or 2B level of evidence, unless a client's benefit plan language explicitly prohibits coverage for off-label use of drugs. They will make good faith efforts to educate their clients about consistent and appropriate off-label use of oncology-related drugs by using NCCN Guidelines and the NCCN Compendium as the basis for coverage decisions. They encourage their clients to adopt this policy as well.
Further, they have attested that their policy is to cover the Routine Costs of Care for individuals enrolled in an Approved Clinical Trial, as defined below, during the course of their cancer treatment unless a client's benefit plan language explicitly prohibits such coverage. They will make good faith efforts to educate clients about the benefits of covering Routine Costs of Care for those enrolled in an Approved Clinical Trial. They encourage their clients to adopt this policy.
Non-payor organizations include those that provide case management, patient management, disease management, utilization review and/or other services. They do not establish or apply their own coverage policies, but rather are obligated to apply their customers' policies.
The non-payor organizations listed below have attested that they support off-label use of drugs and biologics for cancer treatment that are indicated in the version of the NCCN Compendium in place at the time of treatment with Category 1, 2A or 2B level of evidence. They will make good faith efforts to educate their clients about consistent and appropriate off-label use of oncology-related drugs by using NCCN Guidelines and the NCCN Compendium as the basis for coverage decisions.
Further, they have attested that they support coverage of Routine Costs of Care for individuals enrolled in an Approved Clinical Trial, as defined below, during the course of their cancer treatment. They will make good faith efforts to educate clients about the benefits of covering Routine Costs of Care for those enrolled in an Approved Clinical Trial. They encourage their clients to adopt these policies.
NOTE: Recognition applies to the current calendar year; annual attestation is required.
Definitions
An Approved Clinical Trial is a clinical trial that is funded, conducted, or supported by centers or cooperative groups that are funded by any of the following:
An Approved Clinical Trial must also meet the following requirements:
Routine Costs of Care include:
The following items are not considered Routine Costs of Care:
DISCLAIMER: NCCN's recognition is made based upon the company's own assertions. NCCN makes no independent assessment or evaluation of the company's implementation of the policies affirmed. Each organization's attestation reflects its own policies and does not purport to represent the policies of its clients. There is no financial relationship between NCCN and the organization and no fee is paid for this recognition. NCCN disclaims any liability or responsibility of any kind whatsoever, without limitation, for the recognition, for any decisions based upon this recognition or for any consequences related without limitation to the recognition or any decision made by any party, based upon the recognition. NCCN has the right to withdraw its recognition immediately upon becoming aware of any deviation by a recognized company from its affirmation. Such withdrawal shall be noted on this website as well.