The Vermont Statutes Online
The Statutes below include the actions of the 2025 session of the General Assembly.
NOTE: The Vermont Statutes Online is an unofficial copy of the Vermont Statutes Annotated that is provided as a convenience.
Title 8 : Banking and Insurance
Chapter 107 : Health Insurance
Subchapter 011 : PREVENTION AND TREATMENT OF CANCER
(Cite as: 8 V.S.A. § 4095e)-
§ 4095e. Clinical trials for cancer patients
(a) The Commissioner shall, after notice and hearing, adopt rules requiring that all health insurance plans issued in this State provide coverage for routine costs for covered individuals who participate in cancer clinical trials.
(1) Any rules adopted under this section shall be limited to the coverage of routine costs for covered individuals who participate in a cancer clinical trial.
(2) Any rules adopted under this section shall be restricted to approved cancer clinical trials conducted under the auspices of the following cancer care providers (cancer care providers): The University of Vermont Medical Center, the Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, and approved clinical trials administered by a hospital and its affiliated, qualified cancer care providers.
(3) For participation in clinical trials located outside Vermont, coverage under this section shall be required only if the covered individual provides notice to the health insurance plan prior to participation in the clinical trial, and one or more of the following circumstances applies:
(A) no clinical trial is available at the Vermont or New Hampshire cancer care providers described in subdivision (2) of this subsection (a);
(B) the covered individual already has completed a clinical trial at one of the Vermont or New Hampshire cancer care providers described in subdivision (2) of this subsection (a) and the covered individual’s cancer care provider determines that a subsequent clinical trial related to the original diagnosis is available outside the health benefit plan’s network and that participation in that clinical trial would be in the best interests of the covered individual, even if a comparable clinical trial is available at that time at one or both of the Vermont or New Hampshire cancer care providers described in subdivision (2) of this subsection (a); or
(C) the health insurance plan has already approved a referral of the covered individual to an out-of-network cancer care provider and an out-of-network clinical trial becomes available and the covered individual’s cancer care provider determines participation in that clinical trial would be in the best interests of the covered individual, even if a comparable clinical trial is available at one or both of the Vermont or New Hampshire cancer care providers described in subdivision (2) of this subsection (a).
(4) If a covered individual participates in a clinical trial administered by a cancer care provider that is not in the health insurance plan’s provider network, the health insurance plan may require that routine follow-up care be provided within the health insurance plan’s network, unless the cancer care provider determines this would not be in the best interest of the covered individual.
(b) This section shall apply to Medicaid and any other public health care assistance program offered or administered by the State or by any subdivision or instrumentality of the State. (Recodified and amended 2025, No. 11, § 2, eff. September 1, 2025.)
