NABTC Applauds CMS Action to Improve Access to Clinical Trials

March 16, 2010

The North American Brain Tumor Coalition joined others in the patient advocacy community in commending action by the Centers for Medicare & Medicaid Services (CMS) to remove barriers to Medicare beneficiaries’ participation in clinical trials.

Although there has been a policy for Medicare payment of routine patient care costs incurred in clinical trials since 2000, the policy does not include adequate protections for Medicare beneficiaries enrolled in Medicare Advantage (MA) plans. MA enrollees who participate in trials out of their MA plan have been required to pay out-of-network cost-sharing for the routine patient care costs of trials. Most of these patients, who do not have supplemental insurance, have found those costs unaffordably high and have declined to participate in clinical trials as a result.

In its request for proposals for MA plans and prescription drug plans for 2011, CMS proposes to require plans to reimburse beneficiaries for out-of-network cost-sharing associated with clinical trials. Although this appears to be a minor and technical reimbursement matter, it has had significant impact on Medicare Advantage enrollees who were interested in clinical trials participation.

The NABTC joined with others in sending a letter to CMS applauding its proposal for 2011. We will continue to monitor the bidding process to guarantee that this protection is included in 2011 plans. The letter signed by NABTC is attached. Cancer Leadership Council comments on 2011 call letter

Posted in Advocacy Positions, Brain Tumor Research