State Clinical Trials Law
The ACA requires that most, non-grandfathered, group health plans provide coverage for the routine costs when participating in clinical trials. Some states have more consumer protections. Click here for more information about clinical trials.
Florida Clinical Trial Compact
Phase II, Phase III, or Phase IV clinical trials are covered for cancer if the in-network physician recommends participation in the cancer clinical trial.
To be covered, the clinical trial must either involve a drug that is exempt under federal regulations from a new drug application or must be a trial that is approved by (1) A cooperative group or one of the National Institutes of Health; (2) U.S. Food and Drug Administration (FDA), in the form of an investigational new drug application; (3) U.S. Department of Defense; (4) U.S. Department of Veterans Affairs; (5) National Cancer Institute; or (6) An accredited institutional review board of any accredited school of medicine, nursing, or pharmacy or licensed children’s specialty hospital in Florida.
Applies to Health insurance providers who have signed the compact, voluntarily agreeing to provide this coverage. These providers include Humana, Blue Cross Blue Shield Florida, AvMed Health Plans, Vista Healthplan, Aetna, CIGNA, and UnitedHealth Group Florida.
Covers “Routine patient care costs” means the costs of health care services, including drugs, items, devices, and services that would be covered under the patient’s health plan if they were provided outside of a cancer clinical trial. (Effective July 1, 2010) (Current 7/2011)