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.
Agreement: Nebraska Insurance Federation Agreement
Effective: October 16, 2009
What clinical trials are covered?
Phase II, III, and IV clinical trials approved by one of the following:
- National Institutes of Health
- U.S. Food and Drug Administration
- U.S. Department of Defense
- U.S. Department of Veteran Affairs
- National Cancer Institute.
Who is required to pay?
Health benefit providers who are members of the Nebraska Insurance Federation have voluntarily agreed to provide this coverage as part of health insurance contracts that they underwrite.
Other key provisions
- "Routine patient care costs" means the costs associated with health care services that would be covered by the health benefit plan outside of a clinical trial, including items or services that are
- generally available or typically provided under the benefit contract outside of a clinical trial
- intended to diagnose or treat complications
and excluding
- the investigational item or service itself, unless it would be covered outside of the clinical trial
- items or services solely for data collection purposes, to determine eligibility, or that would be paid for or provided free by the trial sponsor in the absence of insurance coverage
- Deductibles or copayments may apply to routine patient care costs in a clinical trial, subject to the terms of the patient's benefit plan.
- Each member of the Nebraska Insurance Federation acts as an independent entity and not as a partner, agent, or joint venturer with any other member. No Federation member may create obligations or liabilities for others.
- Members of the Nebraska Insurance Federation reserve the right to periodically review the administration and efficacy of this agreement and may modify or terminate it.
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