Insurance Coverage: Georgia
What clinical trials are covered?
Phase I, II, III or IV cancer clinical trials for patients with cancer and recommended by a treating physician. The trial must either (1) involve a drug that is currently exempt under federal regulations from a new drug application or (2) be a trial that is approved by one of the following:
- National Institutes of Health (NIH)
- an NIH-sponsored cooperative group or center
- U.S. Department of Defense
- U.S. Department of Veterans Affairs
- U.S. Food and Drug Administration
- An Institutional Review Board of any accredited school of medicine, nursing, or pharmacy in the State of Georgia
Who is required to pay?
- Blue Cross/Blue Shield
- United Healthcare
Other key provisions:
- The agreement also provides for the coverage of cancer screens and examinations in accordance with the most recently published guidelines and recommendations established by any nationally recognized health care organization.
- The Georgia Cancer Coalition agreement covers both adults and children. There is also a law in effect for children only. The law (Senate Bill 603) was passed in 1998 and requires all health plans in Georgia to reimburse the patient care costs associated with a dependent child's participation in a phase II or phase III cancer clinical trial that is testing prescription drugs. The child has to have been diagnosed with cancer prior to his or her nineteenth birthday, and the trial has to have been approved by the U.S. Food and Drug Administration or the U.S. National Cancer Institute.