Illinois Medicaid recipients who have terminal illnesses are now eligible to participate in drug trials. This afternoon, Governor J.B. Pritzker signed Senate Bill 1864 into law, a health care package that includes a proposal by Senator Andy Manar requiring the state’s Medicaid program to cover routine care costs incurred for an approved clinical trial involving the prevention, detection, or treatment of cancer or any other life-threatening disease, as long as Medicaid would normally cover those same routine care costs for a non-clinical procedure.
The Manar initiative was included in a broader health care package passed by the General Assembly during the abbreviated special session in May. Medicare and private insurance carriers are already required to provide coverage for routine care costs in clinical trial participation. Medicaid did not provide routine care costs in clinical trials. The legislation aligns Medicaid coverage for clinical trials with coverage under those insurance plans.
According to a press release from Manar’s office, the routine care costs would be paid by Medicaid if the patient were not on a clinical trial and there would be only a minimal increase to cover those costs within a trial. Manar said in the release that he worked closely with the American Cancer Society to draft the proposal.