President Clinton Orders Medicare to Pay Costs for the Elderly Patients in Clinical Trials.
President Bill Clinton signed an executive memorandum that compels Medicare to pay for the routine costs for elderly patients enrolled in clinical research trials. The directive will compel the Health Care Finance Administration (HCFA) to notify the private insurance companies that process Medicare claims that they should pay for routine patient costs including expenses that arise as a result medical complications from the patient's participation in a clinical trial. The directive has further implications in that private insurers usually will follow federal policy in determining medical expenses that are covered under their policies.
Only a small percentage of elderly people participate in such studies even though many of them are geared towards ailments of the elderly. Up to now Medicare has barred reimbursement for the routine medical care that beneficiaries need when they participate in these clinical trials. Many private insurers have also refused to cover the treatments that they deemed "experimental "or "investigational". The sponsors of the clinical research would continue to pay for the analysis of the data and other expenses beyond the costs of routine care.
As an example of the low participation rate by the elderly in these clinical trials the government pointed to the fact that while 63% of cancer patients are 65 years old or more, only 33% of them are enrolled in clinical trials. Members of Congress including Sen. Connie Mack (Rep.-Fla.) and Sen. John D. Rockefeller (Dem.-W. Va.) have been in the forefront of requesting such coverage. Overall it is estimated that only 1% of the elderly participate in clinical trials. The policy will apply to all diseases and disabilities. It was also pointed out that more than half of all pediatric cancer patients are in clinical trials. This has resulted in about 75% of pediatric cancers now being called curable.
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By Allan Rubin
June 7, 2000
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