House File 768 - Introduced



                                       HOUSE FILE       
                                       BY  COMMITTEE ON COMMERCE

                                       (SUCCESSOR TO HSB 85)


    Passed House,  Date               Passed Senate, Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act providing for an expedited review of denials of health
  2    benefit coverage for certain cancer treatments.
  3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  4 TLSB 1286HV 83
  5 av/nh/8

PAG LIN



  1  1    Section 1.  Section 514F.5, Code 2009, is amended by adding
  1  2 the following new subsection:
  1  3    NEW SUBSECTION.  3.  a.  A person covered under a plan or
  1  4 contract who is participating in an approved cancer clinical
  1  5 trial and has been denied coverage for routine patient care
  1  6 costs because the proposed treatment is experimental may file
  1  7 a written request for an expedited review of the denial by the
  1  8 commissioner of insurance.  The commissioner shall conduct a
  1  9 review of the denial of such coverage and submit its external
  1 10 review decision within three working days of receiving such a
  1 11 request for expedited review.
  1 12    b.  For the purposes of this subsection:
  1 13    (1)  "Approved cancer clinical trial" means a scientific
  1 14 study of a new therapy for the treatment of cancer in human
  1 15 beings to which an enrollee has been referred for cancer
  1 16 treatment by two physicians who specialize in oncology and the
  1 17 cancer treatment is to be given pursuant to a cancer clinical
  1 18 trial that consists of a scientific plan of treatment that
  1 19 includes specified goals, a rationale and background for the
  1 20 plan, criteria for patient selection, specific directions for
  1 21 administering therapy and monitoring patients, a definition of
  1 22 quantitative measures for determining treatment response, and
  1 23 methods for documenting and treating adverse reactions.  In
  1 24 addition, the cancer treatment that is to be provided pursuant
  1 25 to the clinical trial meets all of the following criteria:
  1 26    (a)  The treatment is provided with therapeutic intent and
  1 27 is provided pursuant to a cancer clinical trial that has been
  1 28 authorized or approved by one of the following:
  1 29    (i)  The national institutes of health.
  1 30    (ii)  The United States food and drug administration.
  1 31    (iii)  The United States department of defense.
  1 32    (iv)  The United States department of veterans affairs.
  1 33    (b)  The proposed cancer treatment has been reviewed and
  1 34 approved by the applicable qualified institutional review
  1 35 board.
  2  1    (c)  The available clinical or preclinical data indicate
  2  2 that the cancer treatment will be at least as effective as the
  2  3 standard therapy and is anticipated to constitute an
  2  4 improvement in therapeutic effectiveness for the treatment of
  2  5 the disease in question.
  2  6    (2)  "Institutional review board" means a board, committee,
  2  7 or other group formally designated by an institution and
  2  8 approved by the national institutes of health, office for
  2  9 protection from research risks, to review, approve the
  2 10 initiation of, and conduct periodic review of biomedical
  2 11 research involving human subjects.  "Institutional review
  2 12 board" means the same as "institutional review committee" as
  2 13 used in section 520(g) of the federal Food, Drug, and Cosmetic
  2 14 Act, as codified in 21 U.S.C. } 301, et seq.
  2 15    (3)  "Routine patient care costs" means physician fees,
  2 16 laboratory expenses, and expenses associated with the
  2 17 hospitalization, administration of treatment, and evaluation
  2 18 of a patient during the course of treatment which are
  2 19 consistent with usual and customary patterns and standards of
  2 20 care incurred whenever an enrollee receives medical care, that
  2 21 are associated with an approved cancer clinical trial, and
  2 22 which would be covered if such items and services were
  2 23 provided other than in connection with an approved cancer
  2 24 clinical trial.
  2 25    (4)  "Therapeutic intent" means that a treatment is aimed
  2 26 at improving a patient's health outcome relative to either
  2 27 survival or quality of life.
  2 28                           EXPLANATION
  2 29    This bill provides for an expedited review by the
  2 30 commissioner of insurance of denials of health benefit
  2 31 coverage for routine patient care costs for cancer treatment
  2 32 delivered pursuant to an approved cancer clinical trial
  2 33 because the proposed treatment is experimental.
  2 34    The bill defines "approved cancer clinical trial" as a
  2 35 scientific study of a new therapy for the treatment of cancer
  3  1 in human beings that meets requirements specified in the bill
  3  2 and consists of a scientific plan of treatment.  "Routine
  3  3 patient care costs" is defined to mean physician fees,
  3  4 laboratory expenses, and other expenses associated with
  3  5 treatment administered pursuant to an approved cancer clinical
  3  6 trial that are consistent with usual and customary standards
  3  7 of care and would be covered if provided in connection with
  3  8 other types of medical treatments.
  3  9 LSB 1286HV 83
  3 10 av/nh/8