The CLINICAL TREATMENT Act HR 913 amends title XIX of the Social Security Act to promote access to life-saving therapies for Medicaid enrollees by ensuring coverage of routine patient costs for items and services furnished in connection with participation in qualifying clinical trials, and for other purposes. Read Text
This bill was reintroduced by Rep. Ben Ray Lujan (NM-3) and Rep. Gus Bilirakis (FL-12) and it requires Medicaid to cover routine costs associated with enrollment in approved clinical trials for those with life threatening conditions.
About 1/3 of childhood cancer patients depend on Medicaid coverage for their care. Most children (about 80%) who are treated for cancer are treated in clinical trials, and their routine care is covered by insurance while the research costs of a trial are covered by a sponsor (most often the National Cancer Institute). Today only about a dozen states ( marked in blue above) view clinical trials as standard care. In childhood cancer cases, those states that do not recognize clinical trials as routine standard medical care are leaving families responsible for high expenses for medical care. This bill would require all states Medicaid insurance consider clinical trials standard medical care when there are no other alternatives.