For more information about insurance coverage of clinical trial costs, see this feature's main page: States That Require Health Plans to Cover Patient Care Costs in Clinical Trials.

Legislation: House Bill 6

Effective: February 24, 2005 (extends and modifies legislation in effect since March 2002)

What clinical trials are covered?

Approved cancer clinical trials conducted under the auspices of the following cancer care providers:

• The Vermont Cancer Center at Fletcher Allen Health Care
• The Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center.

If no suitable trial is available at the above locations, the law covers approved cancer clinical trials being administered by a hospital and its affiliated, qualified cancer care providers in or outside the state of Vermont.

Who is required to pay?

All health insurance policies and health benefit plans issued in Vermont, including the Vermont Medicaid program.

Other key provisions:

• Participants in cancer trials located outside Vermont must provide notice to the health benefit plan prior to their participation.
• Health insurers are permitted to require patients participating in a trial outside the provider network to receive routine follow-up care within the plan's network, unless the patient's cancer care provider determines this would not be in the best interest of the patient.
• Cancer care providers and the state's four largest health insurers are required to participate in a cost analysis to determine the impact of the program on health insurance premiums.