- A health insurer shall not limit or deny coverage, or impose additional conditions on the payment for the coverage, of routine patient care costs of items, drugs, and services furnished to a qualified individual in connection with participation in an approved clinical trial. A health insurer shall not be required to pay for costs of items, services, or drugs that are customarily provided by the sponsors of an approved clinical trial.
- In the case of health care services provided by a participating provider, the payment rate shall be at the network negotiated rate, based on the member's plan design. In case of a non-participating provider, the payment shall be at the rate that the member's plan would otherwise pay to a non-participating provider for the same services, less any applicable co-payments and deductibles.
Historical and Statutory
Legislative History of Laws
For Law 17-166, see notes following § 31-2993.01.
DC CODE § 31-2993.02
Current through December 11, 2012
(June 5, 2008, D.C. Law 17-166, § 3, 55 DCR 5174.)