Cancer Clinical Trials:

Medicare Reimbursement Denials

HEHS-98-15R: Published: Oct 14, 1997. Publicly Released: Nov 14, 1997.

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Bernice Steinhardt
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Pursuant to a congressional request, GAO determined the potential effect of the proposed Medical Cancer Clinical Trial Coverage Act by estimating the current rate at which Medicare carriers deny reimbursements for routine patient care costs when beneficiaries are enrolled in cancer clinical trials.

GAO noted that: (1) its survey method did not allow it to give a precise national estimate of the rate at which reimbursement is denied for Medicare beneficiaries enrolled in cancer clinical trials; and (2) the results suggest that denial of reimbursement is relatively rare, given the populations and time period of its review.

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