Manar

SPRINGFIELD – Illinois Medicaid recipients considering clinical trials for cancer treatment would no longer face possible rejection of coverage for care under legislation advanced out of the Senate Human Services Committee by State Senator Andy Manar (D-Bunker Hill) on Wednesday.

“Access to the latest, most advanced cancer treatments can mean the difference between life and death for patients,” Manar said. “I take issue with the fact that some people are granted that access and others aren’t, simply depending on which insurance plan they have. This legislation solves that.”

An initiative of the American Cancer Society, Senate Bill 2499 requires Medicaid 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.

“Because Medicaid beneficiaries tend to be lower income and more diverse, ensuring their participation in clinical trials makes it more likely that new therapies will be tested in a representative population,” said Shana Crews, the Illinois Government Relations Director for the American Cancer Society. “With this bill, the legislature has an opportunity to ensure the viability of new cancer research in our state and to allow an additional one in five Illinois residents to have access to these new, potentially lifesaving treatments and therapies.”

More than 20% of Illinoisans are covered by Medicaid, making it the second largest type of insurance behind Medicare.

Medicare and private insurance carriers are already required to provide coverage for routine care costs in clinical trial participation. SB 2499 would align Medicaid coverage for clinical trials with coverage under those insurance plans. 

If passed, SB 2499 would make Illinois the 14th state Medicaid program – including the District of Columbia – to cover clinical trials for Medicaid beneficiaries.

Because routine costs would be paid for by Medicaid if the patient were not on a clinical trial, there is minimal cost differential for Medicaid to cover these costs within a clinical trial.

SB 2499 will now move to the Senate floor for consideration.

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