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Payer reimbursement policies are a frequently cited barrier. We examined whether state policies that ensure coverage of routine medical care costs for cancer trial participants are associated with an increase in clinical trial enrollment. After implementation of the coverage policies in 1999 in four states, there was a 21.7% (95% CI = 3.8% to 42.6%) annual increase in phase II trial enrollment in coverage states, compared with a 15.6% (95% CI = 8.8% to 21.8%) annual decrease in noncoverage states (P A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser. State Laws Concerning Clinical Trials and Off-Label Drug Use for Cancer Patients. The type of insurer addressed by the law varies by state. All states with laws addressing coverage of clinical trials require insurers to provide coverage of clinical trials.Unfortunately, Evans said, cancer programs are often told by third party payers that they do not cover experimental treatment, ie, the clinical trial, leaving many programs feeling helpless to get their patients coverage to participate.