HB 1540-FN – AS INTRODUCED
2008 SESSION
05/10
HOUSE BILL 1540-FN
AN ACT relative to coverage for clinical trials under the children’s health insurance program and the state Medicaid program.
SPONSORS: Rep. Mickelonis, Straf 1; Rep. Brennan, Straf 1; Rep. Watson, Straf 1
This bill requires the state children’s health insurance program and the state Medicaid program to cover the cost of qualified clinical trials for cancer or other life-threatening conditions.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
08-2596
05/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT relative to coverage for clinical trials under the children’s health insurance program and the state Medicaid program.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Coverage for Qualified Clinical Trials Under State Children’s Health Insurance Program. RSA 415:18-l, VIII is repealed and reenacted to read as follows:
VIII. The provisions of this section shall apply to the New Hampshire healthy kids program, the state children’s health insurance program established in RSA 126-H, and the state Medicaid program. This section shall not apply to the state Medicare program.
2 State Medicaid Plan; Coverage for Qualified Clinical Trials. The department of health and human services shall amend the state Medicaid plan and any implementing regulations to cover qualified clinical trials pursuant to RSA 415:18-l, VIII. On or before January 10, 2009, the department shall submit a report to the speaker of the house of representatives, the senate president, and the governor verifying the steps the department has taken to cover qualified clinical trials under the state Medicaid plan.
3 Effective Date. This act shall take effect 60 days after its passage.
LBAO
08-2596
11/28/07
HB 1540-FN - FISCAL NOTE
AN ACT relative to coverage for clinical trials under the children’s health insurance program and the state Medicaid program.
FISCAL IMPACT:
The Department of Health and Human Services states this bill may increase state and county expenditures by an indeterminable amount in FY 2008 and each year thereafter. This bill will have no fiscal impact on state, county, and local revenue, or local expenditures.
METHODOLOGY:
The Department states this bill seeks coverage of qualified clinical trials by Medicaid and the State Children’s Health Insurance Program (SCHIP). Both Medicaid and SCHIP require state plans to operate, and both could require state plan amendments. SCHIP is administered in partnership with the Healthy Kids Corporation, which in turn contracts with a vendor (Anthem) for provision of coverage to eligible children. The Department states it is possible that their contract would need to be amended to provide this coverage category for SCHIP. The Department states that state law currently prohibits Medicaid from covering experimental treatments (such as clinical trials), and federal law prohibits Medicaid from covering experimental drugs. Assuming that other state statute prohibiting experimental treatment were addressed, the Department states only coverage of non-drug related qualified clinical trials would be subject to the Medicaid federal financial participation (FFP) of 50%. Coverage of qualified clinical drug trials would have to be paid out of state general funds. The Department states they are unable to determine the exact cost of such coverage due to many unknown variables such as how many Medicaid or SCHIP recipients would seek and qualify for a clinical trial; how much the trial would cost; how long the trial would last; and the cost avoidance derived from the success or failure of the clinical trial.
The Department states counties bear some responsibility for Medicaid provided to individuals who receive care in nursing facilities. If the current county share were to remain in place, and if coverage of qualified clinical trials were not limited to individuals in the community, the counties would bear some of the financial responsibility born of this bill.