Clinton Expands Medicare Coverage

Wednesday, June 7th 2000, 12:00 am
By: News On 6

WASHINGTON (AP) — President Clinton today directed Medicare to begin covering costs of routine patient care associated with clinical tests of new drugs and medical treatments.

Clinton is concerned that too few older Americans take part in such trials.

``As America ages, we must provide all our seniors affordable, quality health care, and we should be using our cutting-edge science to meet that challenge,'' Clinton said before leaving for a 36-hour trip to Japan to attend memorial services for Prime Minister Keizo Obuchi.

``Simply put, the more seniors we enroll in trials the faster we'll be able to use these advances to save American lives,'' Clinton said.

As the president made the announcement, the White House released a statement saying: ``With the fast pace of medical advancements and a continuing effort to make evidence-based medical decisions, clinical care serves as the first step toward providing new clinical innovations.''

Only about 1 percent of elderly Americans participate in clinical trials of drugs and treatments even though the elderly are more severely affected by disease than are younger people.

The White House cited findings that 63 percent of cancer patients are older than 65 but people that age make up only 33 percent of those enrolled in clinical trials.

The disparity is greater for breast cancer patients. Elderly women are 44 percent of breast cancer patients, but only 1.6 percent of women over 65 are in clinical trials for the disease.

The administration said current Medicare reimbursement policy could discourage older people from taking part in clinical trials because the investigators running the tests cannot be sure that Medicare will pay for the care.

As a result, older people considering whether to enter the trials may be responsible for costs simply because they are taking part in a test and investigators and research centers often are reluctant to recruit older people because of the uncertainty of Medicare reimbursement.

Medicare covers 39 million elderly and disabled Americans. Many private insurers follow its example in deciding what to cover.

The White House cited progress in treating the youngest patients as evidence that greater participation in clinical trials by older people is worthwhile. For decades, more than 50 percent of pediatric cancer patients have been enrolled in clinical trials, the White House said, and today 75 percent of cancers in children are curable.

Clinton directed the Department of Health and Human Services to revise Medicare guidelines to explicitly authorize payment for routine patient care associated with clinical trials. This week, the Health Care Financing Administration will put out word to Medicare contractors that these costs are reimbursable. Clinton also wants a tracking system for Medicare payment for test costs.

The underlying Medicare law has been interpreted to bar reimbursement for routine medical care needed when beneficiaries participate in clinical trials. Many private insurers also deny coverage on grounds the treatments were experimental.

Vice President Al Gore, who is campaigning for the presidency, has been advocating Medicare coverage of such clinical trials.