{"data":{"id":"us-ky/krs-304.17a-136","jurisdiction":"us-ky","citation":"KRS 304.17A-136","heading":"Coverage for cancer clinical trials.","body":"(1) As used in this section, unless the context requires otherwise:\n(a) \"Cancer clinical trial\" means a clinical trial that:\n1. Is approved by:\na. The  National Institutes of Health, or any institutional review\nboard recognized by the National Institutes of Health;\nb. The United States Food and Drug Administration;\nc. The United States Department of Defense; or\nd. The United States Department of Veterans Affairs; and\n2. Does one (1) of the following:\na. Tests how to administer a health care service, item, or drug for\nthe treatment of cancer;\nb. Tests responses to a health care service, item, or drug for the\ntreatment of cancer;\nc. Compares  the effectiveness of health care services, items, or\ndrugs for the treatment of cancer with that of other health care\nservices, items, or drugs for the treatment of cancer; or\nd. Studies new uses of health care services, items, or drugs for\nthe treatment of cancer; and\n(b) \"Routine patient healthcare costs\" means  all healthcare services, items,\nand drugs for the treatment of cancer, except for the following:\n1. The  health care service, item, or investigational drug that is the\nsubject of the cancer clinical trial;\n2. Any treatment modality outside the usual and customary standard of\ncare required to administer or support the healthcare service, item,\nor investigational drug that is the subject of the cancer clinical trial;\n3. Any healthcare service, item, or drug provided solely to satisfy data\ncollection and analysis needs that are not used in the direct clinical\nmanagement  of the patient;\n4. An  investigational drug or device that has not been approved for\nmarket by the United States Food and Drug Administration;\n5. Transportation, lodging, food, or other expenses for the patient or a\nfamily member  or companion of the patient that are associated with\ntravel to or from a facility providing the cancer clinical trial;\n6. Any  services, items, or drugs provided by the cancer clinical trial\nsponsors free of charge for any new patient; or\n7. Any services, items, or drugs that are eligible for reimbursement by\na person other than the insurer, including the sponsor of the clinical\ntrial.\n(2) A health benefit plan shall not exclude coverage for routine patient healthcare\ncosts that are incurred in the course of a cancer clinical trial if the health benefit\nplan would provide coverage for the routine patient healthcare costs had they\nnot been incurred in a cancer clinical trial.\n(3) The coverage that may not be excluded under this section shall be subject to\nall terms, conditions, restrictions, exclusions, and limitations that apply to any\nother coverage under the policy, plan, or contract, including the treatment\nunder the policy, plan, or contract of services performed by participating and\nnonparticipating providers.\n(4) (a) Nothing in this section requires a policy, plan, or contract to offer cancer\nclinical trial services by a participating provider.\n(b) Nothing in this section prohibits a policy, plan, or contract from offering\ncancer clinical trial services by a participating provider.\n(c) Nothing in this section requires services that are performed in a cancer\nclinical trial by a nonparticipating provider of a policy, plan, or contract to\nbe  reimbursed at the same  rate as those performed by a participating\nprovider of the policy, plan, or contract.\n(5) Nothing in this section shall be construed as imposing a new health benefit\nmandate.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45840","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:46Z","sha256":"483f46df3f37f9d1b63befe1de80c8feadc7b677773d4e8d43fef2d6ac130149","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-135","next":"us-ky/krs-304.17a-137"},"notice":"GroundRules: Original legal text. Not legal advice."}