SB 10 Summary

• Health care insurers must cover routine patient care costs for patients enrolled in approved cancer-related clinical trials, including trials for leukemia, lymphoma, and bone marrow stem cell disorders.

• Coverage is required only when the treating physician determines no clearly superior noninvestigational treatment alternative exists and clinical data provide reasonable expectation the trial treatment will be at least as effective as non-investigational alternatives.

• Covered costs include prevention, diagnosis, treatment, and palliative care; medical care otherwise covered by insurance; items necessary to provide investigational services; complication treatment; FDA-approved drugs or devices; and transportation essential to medical care.

• Coverage excludes unapproved investigational drugs or devices, housing, companion expenses, data collection-only items, normally-excluded plan items, and items paid through grants or other funding; coverage remains subject to standard deductibles and copayments.

• Department of Health and Social Services shall provide Medicaid services to eligible persons participating in approved clinical trials, and the Comprehensive Health Insurance Association's state plan may cover experimental procedures during approved clinical trials.