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: House Bill 837 ²

Effective: July 2005

What clinical trials are covered?

Phase I, II, III, and IV clinical trials for the treatment of cancer approved by one of the following:

• National Institutes of Health (NIH)
• U.S. Food and Drug Administration (FDA), in the form of an Investigational New Drug Application
• U.S. Department of Defense
• U.S. Department of Veterans Affairs

Who is required to pay?

• Any health benefit plan offered by an employer, including managed care organizations; excludes individually underwritten health insurance policies.

Other key criteria:

• The subject of the trial must evaluate a drug, medical device or service that falls within a Medicare benefit category.
• Limits coverage to those drugs, medical devices, and services that have been approved by the FDA and that are used in the clinical management of the patient.