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Urge Congress to Support Medicaid Coverage of Routine Care Costs for Clinical Trials


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MEMBERS OF CONGRESS recently reintroduced bipartisan legislation, the ‘Covering Life-Saving Investigations Needed in Cancer and Other Life-Threatening Conditions Through Timely Use of Resources for Easy and Affordable Treatment from Medicaid for Enrollees in Need Today Act,’ or the CLINICAL TREATMENT Act (H.R. 913). The bill would guarantee coverage of the routine care costs of clinical trial participation for Medicaid enrollees with a life-threatening condition. ASCO worked closely with the bill’s sponsors, Representatives Ben Ray Lujan (D-NM-03) and Gus Bilirakis (R-FL-12), to shape the legislation to address a significant barrier to participation in clinical trials. The Society also led a community endorsement letter that 86 organizations signed, thanking the sponsors for their leadership on this issue and urging Congress to advance the legislation.

Nearly 20% of Americans receive their health insurance coverage through Medicaid. However, unlike Medicare and private and commercial payers, Medicaid is not federally required to cover routine care costs (like physician visits and laboratory studies) for clinical trials.

Passing the CLINICAL TREATMENT Act would:

Improve quality of cancer research: Medicaid insures a large portion of people from underrepresented minority and ethnic groups who are not well represented in clinical trial enrollment. Improving the representation of this group in clinical trials would improve the validity of clinical research data and the quality of new treatments.

Reduce disparities in cancer care: Clinical trials often provide people with cancer with their best clinical option. Covering routine costs of clinical trials for patients with Medicaid coverage could help to reduce health disparities and ensure access to the high-quality, high-value cancer care.

Cover only routine costs of care: Providing coverage for the routine costs of clinical trials would have a minimal effect on overall care costs, since the cost of the investigational device or drug would still be covered by the trial sponsor.

Go to ASCO’s advocacy center (asco.quorum.us) and tell Congress to support the CLINICAL TREATMENT Act, and visit asco.org/asco-in-action for the latest in cancer policy and practice news.

© 2019. American Society of Clinical Oncology. All rights reserved.


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