For more information about insurance coverage of clinical trial costs, see this feature's main page: States That Require Health Plans to Cover Patient Care Costs in Clinical Trials 1. Legislation: Senate Bill 1026 2; Senate Bills 567 & 792 3 Effective: August 28, 2002 (S.B. 1026); May 12, 2006 (S.B. 567 & 792) What clinical trials are covered? Phase II, III or IV clinical trials for the prevention, early detection, or treatment of cancer, as approved or funded by one of the following: National Institutes of Health (NIH) NIH Cooperative Group or Center U.S. Food and Drug Administration U.S. Department of Defense U.S. Department of Veterans Affairs An Institutional Review Board in Missouri that has been approved by the U.S. Department of Health and Human Services A qualified research entitity that meets the criteria for NIH Center support grant eligibility Who is required to pay? All health benefit plans operating in the state. Other key provisions: There must be identical or superior noninvestigational treatment alternatives available before providing clinical trial treatment, and there must be a reasonable expectation that the clinical trial treatment will be superior to the noninvestigational alternatives. Requires coverage of FDA-approved drugs and devices used in cancer clinical trials even if those drugs and devices have not been approved for use in treatment of the patient's particular condition. Health benefit plans may limit coverage of routine care costs of patients in phase II trials to those facilities within the plans' provider network. For individually underwritten health plans, the phase II provision is not mandatory but must be offered as an option.