ID S1097

Creates Chapter 65 of Title 41, Idaho Code to require health benefit plan issuers to cover routine patient care costs for enrollees participating in approved clinical trials.

Defines "routine patient care costs" as medically necessary services covered under the plan, excluding investigational drugs/devices not FDA-approved, non-health care services, services inconsistent with established standards of care, trial management costs, and specifically excluded services.

Establishes that approved clinical trials must be phase I-IV studies related to disease prevention, detection, or treatment that are approved or funded by specified federal agencies (NIH, CDC, CMS, etc.), conducted under FDA investigational new drug application, or reviewed by an institutional review board.

Prohibits insurers from canceling or refusing to renew coverage solely because an enrollee participates in a clinical trial and limits insurer liability for adverse trial effects.

Allows deductibles, coinsurance, and copayments comparable to other plan requirements and exempts insurers from reimbursing research institutions unless they accept plan rates as payment in full.