THU AM News: GOP bill would require insurers to cover certain clinical trial costs; Open enrollment period begins

— Sen. Andre Jacque is seeking cosponsors for a bill that would require health insurers to cover certain costs related to participating in a clinical trial. 

In a memo sent to other lawmakers, the De Pere Republican says the legislation aims to ensure clinical trial participants don’t face “unnecessary denial and interruption of coverage and delays in life-saving care” due to their insurer not covering related costs. 

He notes these patients may need to see out-of-network specialists during clinical trials, and denial of coverage can lead to them missing out on participating and receiving potentially lifesaving treatment. 

“The Clinical Trial Coverage Act would address this problem by requiring insurers to cover out-of-network routine care costs for clinical trial participants if no in-network provider is available, ensuring families have at least some peace of mind at a time of great stress and access to clinical trials without paying significant out-of-pocket costs for physician services,” Jacque wrote in the memo. 

Federal law currently requires private insurers to cover “routine services” for these trials from in-network providers, the memo shows. But some patients’ networks may not include the correct providers, leaving them to pay the full price for clinical trial-related services.