Added by section 10103 of the Manager’s Amendment. Provides that group or individual plans may not deny individuals participation in a clinical trial, deny or limit coverage for routine costs or discriminate on the basis of such participation.
Specifies conditions for inclusion of routine patient costs and defines qualified individual and approved clinical trial. Notes that a plan or issuer may require that a qualified individual participate in the trial through an in-network participating provider if the provider will accept the individual, adding that the section’s protections nonetheless apply to a qualified individual participating in an approved clinical trial that is conducted outside the State in which the qualified individual resides.
Effective for plan years beginning on or after January 1, 2014.