publication date: Feb. 21, 2020

Coalition of cancer groups urges Congress to include clinical trial-related coverage under Medicaid

By Alexandria Carolan

A coalition of over 100 cancer groups is urging Congress to include the Clinical Treatment Act (HR-913) in an upcoming health care extenders package, scheduled to be considered this spring.

Most notably, the act would ensure clinical trial coverage for patients who receive Medicaid.

The coalition, representing patients, providers, medical researchers, survivors, and families who support the measure, sent a letter to leaders from the Senate and House of Representatives Feb. 18.

The bill would guarantee coverage of the routine care costs of clinical trial participation for Medicaid enrollees with a life-threatening condition.

“This coverage is already assured for Medicare beneficiaries and for patients with private health insurance,” the letter says. “Although 11 states require their Medicaid programs to cover these costs, there are still as many as 42.2 million Medicaid patients that are potentially without this needed coverage.”

Medicaid, unlike Medicare and commercial payers, is not required by federal law to cover routine care costs for clinical trials. Nearly 20% of Americans receive their health insurance through Medicaid. Without guarantee of coverage, many Medicaid beneficiaries with life-threatening conditions do not have the latest technological and scientific advancements as a treatment option.

“Importantly, clinical trials often provide patients with the best—perhaps only—treatment option for their condition,” the letter says. “Without the guarantee of coverage, however, many Medicaid beneficiaries do not have the latest technological and scientific advancements as a treatment option.”

Routine costs only include the non-experimental costs of treating a patient who is participating in a clinical trial, and so adoption of … Continue reading Coalition of cancer groups urges Congress to include clinical trial-related coverage under Medicaid

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