Insurance-Provider Reference for Qualified Clinical Studies
Below are some resources from common insurance providers that may provide information to ensure that aspects of medical billing and collections are handled in accordance with the applicable policies and legislation.
All insurance providers’ policies differ, check with your insurer for complete information about your individual plan.
For more information on Medicare coverage and the Clinical Trials Final National Coverage Decision NCD, please visit the U.S. Department of Health & Human Services CMS Medicare Coverage Database. The current policy, National Coverage Determination (NCD) for Routine Costs in Clinical Trials (310.1), effective July 9, 2007 is available here.
The Virginia Legislation provides information in Title 38.2-3418.8: Coverage for clinical trials for treatment studies on cancer and Title 38.2-3453: Clinical trials. The Commonwealth of Virginia Mandated Benefits and Mandated Offers are available here.
Coverage for individuals participating in clinical trials is available here. Coverage for Members in Clinical Trials is available here. Effective January 1, 2014.
Clinical Trials Fact Sheet is available here. Updated May, 2014.