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 1235 ², House Bill 871 ³

Effective: July 1999

What clinical trials are covered?

Phase II, III, and IV cancer treatment trials, with Phase I trials covered on a case-by-case basis. Trial must be approved by one of the following:

• National Cancer Institute (NCI)
• NCI cooperative group or center
• U.S. Food and Drug Administration
• U.S. Department of Defense
• U.S. Department of Veterans Affairs
• An Institutional Review Board of a Virginia institution with a Multiple Project Assurance (MPA) from the U.S. Department of Health and Human Services' Office for Human Research Protections.

Who is required to pay?

Private insurers, specified managed care plans, and public employee health plans.

Other key provisions:

• There is no clearly superior, noninvestigational alternative.
• Data provide a reasonable expectation that the treatment will be at least as effective as the alternative.