Insurance Coverage: Massachusetts
Legislation: House Bill 4376 (Chapter 257)
Effective: January 2003
What clinical trials are covered?
All phases of cancer treatment trials.
Trial must be peer-reviewed and 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
- A qualified non-government research entity
Who is required to pay?
Individual and group insurers, including health maintenance organizations.
Other key provisions:
- Insurers must provide payment for services that are "consistent with the usual and customary standard of care" provided under the trial's protocol and that would be covered if the patient did not participate in the trial.