Medicaid of Hawaii Agrees to Start Paying Beneficiaries’ Participating in University of Hawaii Clinical Trials

Jan 25, 2020 | Access, Cancer Research as Care Option, Clinical Trials, Medicaid, Payer

Medicaid of Hawaii Agrees to Start Paying Beneficiaries’ Participating in University of Hawaii Clinical Trials

The State of Hawaii Department of Human Services Med-QUEST Division, a patient-centric Medicaid program, has worked with the University of Hawaii Cancer Center to ensure access to clinical trials for cancer patients in Hawaii. On the topic, Med-QUEST issued a memorandum “to provide guidance regarding the coverage of routine costs associated with qualifying clinical trials” for prevention, diagnosis, treatment, or supportive care of cancer.

Med-QUEST Makes the Move to Cover Clinical Trials Costs

Med-QUEST cancer patients in Hawaii receive coverage for routine care costs such as doctors’ visits and laboratory tests. Med-QUEST, unlike Medicare and private insurance, is not federally required to cover these routine care costs for patients participating in clinical trials. This policy guidance will ensure equal access to the best treatments available on clinical trials for Med-QUEST cancer patients.

An Exceptional Move on the Part of Hawaii

Although there is no formal legislation mandating reimbursement for clinical trials, the State of Hawaii went ahead and approved the coverage for clinical trials. Jessica Rhee, MD, UH Cancer Center’s Clinical Trials Office medical director reported, “Hawaii was one of only a dozen states without legislation or a formal policy to provide coverage of routine care costs associated with cancer clinical trial participation for Medicaid beneficiaries, who make up about one-quarter of the state’s population and over 40% of all of the children. The guidance clarified that Medicaid patients can participate in clinical trials which offer the best treatment options and the highest quality of care for cancer patients.”

Grace Lee, a member of the community-based Patient Advocacy Committee (PAC), reported, “This is a major step forward and something that we have been discussing with Dr. Rhee for many months. As a lung cancer survivor who was told I had six to 12 months, I know the importance of having access to and coverage for any and all cancer treatment options.”

This effort aligns with the mission of the UH Cancer Center to reduce the burden of cancer through research, education, patient care, and community outreach. It will particularly benefit patients from our low-income communities by providing access to innovative and high-quality, cost-effective care.

Med-QUEST Key Figure

Dr. Judy Mohr Peterson has been working hard behind the scenes to help the state’s most at need patients. She knows that in the United States, nearly 80 million are now Medicaid beneficiaries. With the transformation to a service economy, globalization, union reduction, and a whole range of other factors, the middle class isn’t necessarily bigger. Yet, the health care needs increase and Medicaid, state to state, has served as a vital function for health access.

Randall Holcombe, MD, UH Cancer Center director noted: “I am very appreciative to Dr. Judy Mohr Peterson, Med-QUEST division administrator, Dr. Curtis Toma, Med-QUEST medical director and Dr. Jessica Rhee for working so diligently and collaboratively to create a policy that addresses the needs of some of the most vulnerable cancer patients in Hawaii.” He continued, “This is an effort supported by multiple state legislators and healthcare organizations, Hawaii Society of Clinical Oncology, and the Hawaii chapters of American Cancer Society and Susan G. Kormen.

On the policy, Judy Mohr Peterson herself declared, “I believe clinical trials coverage should be available to all cancer patients. I am a product of the work we have done to ensure Hawaii’s Medicaid enrollees have access to the most novel and potentially lifesaving treatments through clinical trials.”

TrialSite News Comment on Hawaii Medicaid Move

TrialSite News applauds Hawaii and its access policy. With nearly 80 million Medicaid beneficiaries across the United States, this population is often under-served and in some geographic regions represents large African American, Latino and Asian and Pacific Islander populations. TrialSite News has long believed that Medicaid programs represent a significant access point for those that could benefit from clinical research as a care option. More states should follow this lead.

Call to Action: For those in Hawaii that are interested in learning more, they can reach the UH Cancer Center clinical trials at (808) 586-2979.


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