Coverage of Routine Costs in Clinical Trials by Medicare Advantage Organizations

Posted By: Alan C. Hartford MD Latest News,

The Council of the New Hampshire Medical Society has introduced a resolution to the AMA focusing on harmful policies of Medicare Advantage Organizations (MAOs) that affect patients who enroll on clinical trials, policies covering the entire gamut of all clinical medicine.   In the past months New Hampshire patients enrolled on trials have been seeing bills, many in the thousands of dollars, that arose merely because these patients elected to sign up for a study.

Per current Medicare rules, although the MAO is legally required to pay these routine costs, it need only do so after the patient has received the bills (unlike what the MAO otherwise would have been required to do absent the clinical trial) – a practice that creates anger, confusion, and frustration for these patients and that results in a profound disincentive for patients to enroll in clinical research.  This burden is even worse for marginalized groups who for decades have been underrepresented in clinical trials. 

This New Hampshire resolution now is being co-sponsored by several national specialty societies, including the American Society of Clinical Oncology (ASCO), the American Society for Therapeutic Oncology (ASTRO), the American College of Radiation Oncology (ACRO), and the Association of University Radiologists (AUR), as well as by all six of our New England states.  Representing the NHMS, P. Travis Harker, MD, and Alan Hartford, MD, PhD (the original author), will be presenting the resolution to the AMA at its Annual Meeting in Chicago this June.

Click here to read the resolution.