For more information about insurance coverage of clinical trial costs, see this feature's main page: States That Require Health Plans to Cover Patient Care Costs in Clinical Trials ¹.

Legislation: Senate Bill 325 ²

Effective: January 2002

What clinical trials are covered?

Clinical trials for treatment, palliation (supportive care), or prevention of cancer approved by one of the following:

• National Institutes of Health (NIH)
• National Cancer Institute cooperative group or center
• U.S. Food and Drug Administration
• U.S. Department of Defense
• U.S. Department of Veterans Affairs

Who is required to pay?

Private insurers, including individual and group health plans.

Other key criteria:

• Prevention trials are covered only in Phase III and only if they involve therapeutic intervention.
• Insurer may require documentation of the likelihood of therapeutic benefit, informed consent, protocol information and test results, and/or a summary of costs involved.