State Medicaid Coverage of Clinical Trials
This chart highlights the state laws related to Medicaid coverage of clinical trials.
For more information, visit our Medicaid Topics Page.
| State | Medicaid Coverage of Clinical Trials Routine Costs | Details of Medicaid Coverage for Clinical Trials Routine Costs | |
|---|---|---|---|
| ALABAMA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| ALASKA | x (also covered under federal law) | http://www.akleg.gov/basis/Bill/Text/26?Hsid=SB0010Z | Health care insurers in the state must cover routine costs associated with clinical trials “designed to test and improve prevention, diagnosis, treatment or palliation of cancer.” Directs insurers to provide Medicaid services for individuals participating in these trials. |
| ARIZONA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| ARKANSAS | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| CALIFORNIA | x (also covered under federal law) | http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=200120020SB37 | If a patient’s physician recommends a clinical trial, every health care insurer in the state (including Medi-Cal) must cover routine costs associated with that trial. Effective August 10, 2001 (SB 37) |
| COLORADO | x (also covered under federal law) | https://leg.colorado.gov/bills/hb20-1232 | If a patient's physician determines that the patient has a life-threatening or debilitating disease or condition, Medicaid will cover the routine costs associated with an approved clinical trial. Effective July 10, 2020 (HB20-1232). |
| CONNECTICUT | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| DELAWARE | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| *DISTRICT OF COLUMBIA | x (also covered under federal law) | https://code.dccouncil.gov/us/dc/council/code/titles/31/chapters/29B | Under state health insurance code 31-2993.02 (October 23, 2012), the District of Columbia Medicaid agency may not “not limit or deny coverage, or impose additional conditions on the payment for the coverage, of routine patient care costs” associated with clinical trials. |
| FLORIDA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | Florida Administrative Code 59G-1.036 (January 6, 2006) requires that “Florida Medicaid reimburses for services as a result of a recipient participating in a clinical trial.” |
| GEORGIA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| HAWAII | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| IDAHO | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| ILLINOIS | x (also covered under federal law) | https://www.ilga.gov/legislation/ilcs/fulltext?DocName=030500050K5-5.27 | Under Public Act 101-0649, the state's Medicaid program covers "routine care costs that are incurred in the course of an approved clinical trial if the medical assistance program would provide coverage for the same routine care costs not incurred in a clinical trial." Effective July 7, 2020. |
| INDIANA | x (also covered under federal law) | https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-15-5-9-2.html | Medicaid program must provide coverage for routine care costs that are incurred in the course of a clinical trial if the Medicaid program would provide coverage for the same routine care costs not incurred in a clinical trial |
| IOWA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| KANSAS | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| KENTUCKY | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| LOUISIANA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| MAINE | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| MARYLAND | x (also covered under federal law) | https://mmcp.health.maryland.gov/healthchoice/Documents/MCO%20Agreement%202019%20for%20CY%202019%20MCO%20file.pdf | Section .26-1 of Maryland’s Medicaid managed care organization agreement mandates that Maryland managed care organizations cover routine costs associated with clinical trials. |
| MASSACHUSETTS | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| MICHIGAN | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| MINNESOTA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | A health plan company cannot deny participation by a qualified individual in an approved clinical trial; deny, limit, or impose additional conditions on the coverage of routine patient costs for items or services furnished in connection with participation in the trial; or discriminate against an individual on the basis of an individual's participation in an approved clinical trial. |
| MISSISSIPPI | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| MISSOURI | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| MONTANA | x (also covered under federal law) | https://legiscan.com/MT/text/SB55/id/791917 | Health insurance providers, including Medicaid, may not deny patients’ participation in an approved clinical trial, deny coverage of routine patient costs, or discriminate against an individual due to their participation in an approved clinical trial. |
| NEBRASKA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| NEVADA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | The Healthy Kids Program policy #15-1 (November 1, 2014) requires Medicaid to cover routine costs for phase III and IV clinical trials for children less than 21 years old. |
| NEW HAMPSHIRE | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| NEW JERSEY | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| NEW MEXICO | Covered under federal law | https://www.nmlegis.gov/Sessions/09%20Regular/final/SB0042.pdf | As of 2009, New Mexico insurance code requires that all health care insurers in the state (including Medicaid) cover routine costs associated with clinical trials. |
| NEW YORK | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| NORTH CAROLINA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | As of October 1, 2015, North Carolina Medicaid programs cover qualifying clinical trials’ routine costs. |
| NORTH DAKOTA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| OHIO | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| OKLAHOMA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| OREGON | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| PENNSYLVANIA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| *PUERTO RICO | |||
| RHODE ISLAND | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| SOUTH CAROLINA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| SOUTH DAKOTA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| TENNESSEE | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| TEXAS | x (also covered under federal law) | https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1379.htm | All health care insurers in the state, including Medicaid Plans, must cover routine costs associated with approved “clinical trials conducted in relation to the prevention, detection, or treatment of a life-threatening disease or condition.” (Insurance Code Section 1379.001) |
| UTAH | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| VERMONT | x (also covered under federal law) | https://dfr.vermont.gov/reg-bul-ord/health-insurance-coverage-cancer-clinical-trial | Vermont’s Health Care Administration requires Vermont Medicaid providers to cover routine costs associated with clinical trials as of August 5, 2005. (Regulation H-2005-03) |
| VIRGINIA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| WASHINGTON | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| WEST VIRGINIA | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| WISCONSIN | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| WYOMING | Covered under federal law | https://www.congress.gov/bill/116th-congress/house-bill/133/text | |
| GUAM | |||
| LAST UPDATE | 8/1 |