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Insurance Coverage: California
    Posted: 12/19/2002    Reviewed: 08/23/2005
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For more information about insurance coverage of clinical trial costs, see this feature's main page: States That Require Health Plans to Pay for Clinical Trial Costs.


Legislation: Senate Bill 37

Effective: August 2001

What clinical trials are covered?

Phase I, II, III, and IV clinical trials with a therapeutic intent for patients with cancer and recommended by a treating physician. Trial must either involve a drug exempt from a New Drug Application (NDA) under federal regulations, or be approved by one of the following:

  • National Institutes of Health (NIH)
  • U.S. Food and Drug Administration
  • U.S. Department of Defense
  • U.S. Department of Veterans Affairs

Who is required to pay?

All California insurers, including the state's Medicaid program and other medical assistance programs.

Other key criteria:

  • Plan may restrict coverage to services in California unless protocol is not provided at a California hospital or by a California physician.

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