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Clinical Trials

The Consolidated Appropriations Act of 2021 adds a mandatory Medicaid benefit at 1905(a)(30) of the Social Security Act for coverage of routine patient costs for services provided to a Vermont Medicaid member participating in a qualified clinical trial.

Vermont Medicaid has always provided coverage for covered services related to clinical trials.  The item or service that is under investigation remains non-covered. Submission of the Clinical Medicaid Attestation Form below is required. If transportation is necessary for the member to get to the clinical trial, submission of the Non-Emergency Medical Transportation (NEMT) Physician Referral Form is required (see below).

When submitting claims for covered services the Clinical Trial Attestation form only needs to be submitted once with the initial/first claim.