National Cancer Institute National Cancer Institute
U.S. National Institutes of Health National Cancer Institute
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    Posted: 12/19/2002    Updated: 06/01/2009
States That Require Health Plans to Cover Patient Care Costs in Clinical Trials

A growing number of states have passed legislation or instituted special agreements requiring health plans to pay the cost of routine medical care you receive as a participant in a clinical trial.

Links on this page

Map (click on a blue-highlighted state/location to see the law or agreement and its key provisions)

Information by State (All States 1)
Alabama
Alaska
Arizona 2
Arkansas
California 3
Colorado
Connecticut 4
Delaware 5
Florida
Georgia 6
Hawaii
Idaho
Illinois
Indiana 7
Iowa
Kansas
Kentucky
Louisiana 8
Maine 9
Maryland 10
Massachusetts 11
Michigan 12
Minnesota
Mississippi
Missouri 13
Montana
Nebraska
Nevada 14
New Hampshire 15
New Jersey 16
New Mexico 17
New York
North Carolina 18
North Dakota
Ohio 19
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island 20
South Carolina
South Dakota
Tennessee 21
Texas
Utah
Vermont 22
Virginia 23
Washington
Washington, D.C. 24
West Virginia 25
Wisconsin 26
Wyoming 27

Overview of the issue

"Routine patient care costs" are the usual costs of medical care, such as doctor visits, hospital stays, clinical laboratory tests, x-rays, etc., that you would receive whether or not you were participating in a clinical trial. Some health plans don't cover these costs once you join a trial, even though studies have shown that they are not appreciably higher than costs for patients who are not enrolled in trials. (See Cost of Clinical Trials 28.)

Lack of such coverage is a significant barrier to many patients who might otherwise enroll in a trial. Lack of coverage also makes it harder for researchers to successfully conduct trials that could improve prevention and treatment options.

These laws and agreements do not cover the research costs associated with the conduct of the trial, such as tests purely performed for research purposes. In most cases, such costs would be paid for by the group sponsoring the trial, such as the National Cancer Institute or a pharmaceutical company.

For more of an overview, see Clinical Trials and Insurance Coverage: A Resource Guide 29.

Other Resources

Delaware Tennessee Wisconsin West Virginia New Jersey Vermont New Hampshire Maine Missouri Maryland Louisiana Georgia North Carolina Virginia Ohio Indiana Michigan Rhode Island Michigan Nevada Washington, DC Wyoming Connecticut California New Mexico Arizona Massachusetts



Table of Links

1http://www.cancer.gov/clinicaltrials/ctlaws-allstates
2http://www.cancer.gov/clinicaltrials/ctlaws-az
3http://www.cancer.gov/clinicaltrials/ctlaws-ca
4http://www.cancer.gov/clinicaltrials/ctlaws-ct
5http://www.cancer.gov/clinicaltrials/ctlaws-de
6http://www.cancer.gov/clinicaltrials/ctlaws-ga
7http://www.cancer.gov/clinicaltrials/ctlaws-in
8http://www.cancer.gov/clinicaltrials/ctlaws-la
9http://www.cancer.gov/clinicaltrials/ctlaws-me
10http://www.cancer.gov/clinicaltrials/ctlaws-md
11http://www.cancer.gov/clinicaltrials/ctlaws-ma
12http://www.cancer.gov/clinicaltrials/ctlaws-mi
13http://www.cancer.gov/clinicaltrials/ctlaws-mo
14http://www.cancer.gov/clinicaltrials/ctlaws-nv
15http://www.cancer.gov/clinicaltrials/ctlaws-nh
16http://www.cancer.gov/clinicaltrials/ctlaws-nj
17http://www.cancer.gov/clinicaltrials/ctlaws-nm
18http://www.cancer.gov/clinicaltrials/ctlaws-nc
19http://www.cancer.gov/clinicaltrials/ctlaws-oh
20http://www.cancer.gov/clinicaltrials/ctlaws-ri
21http://www.cancer.gov/clinicaltrials/ctlaws-tn
22http://www.cancer.gov/clinicaltrials/ctlaws-vt
23http://www.cancer.gov/clinicaltrials/ctlaws-va
24http://www.cancer.gov/clinicaltrials/ctlaws-dc
25http://www.cancer.gov/clinicaltrials/ctlaws-wv
26http://www.cancer.gov/clinicaltrials/ctlaws-wi
27http://www.cancer.gov/clinicaltrials/ctlaws-wy
28http://cancer.gov/clinicaltrials/digestpage/cost
29http://www.cancer.gov/clinicaltrials/understanding/insurance-coverage
30http://www.cancer.gov/clinicaltrials/search
31http://www.cancer.gov/clinicaltrials/learning
32http://www.cancer.gov/clinicaltrials/understanding/what-is-a-clinical-trial
33http://www.scld-nci.net