Affordable Care Act Requirements for Private Insurance Coverage

Posted: Feb 12, 2014
American Society of Clinical Oncology.
KEYWORDS: Cost/Insurance, Insurance Coverage, Cancer, Prevention, Screening, Treatment, Phase 0,1,2, Phase 3-4


The Patient Protection and Affordable Care Act (ACA) requires that private insurers cover the routine costs associated with participation in approved clinical trials. This collection of resources provides further information about the requirement and the implementation process. 



The provision prohibits health plans or insurance issuers from:

  • Denying participation in clinical trials
  • Denying or limiting coverage of routine patient costs, subject to the plan's out-of-network coverage policy; and/or
  • Discriminating against the individual on the basis of participation in a trial.