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Legislative Year: 2023 Change
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Bill Detail: HB23-1110

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Title Health-care Coverage For Biomarker Testing
Status Introduced In House - Assigned to Health & Insurance (01/23/2023)
Bill Subjects
  • Health Care & Health Insurance
House Sponsors D. Michaelson Jenet (D)
A. Hartsook (R)
Senate Sponsors K. Mullica (D)
J. Rich (R)
House Committee Health and Insurance
Senate Committee
Date Introduced 01/23/2023
Summary

The bill requires all individual and group health benefit plans to
provide coverage for biomarker testing if the testing is supported by
medical and scientific evidence. Biomarker testing is defined as an
analysis of a patient's tissue, blood, or other biospecimen for the presence
of an indicator of normal biological processes, pathogenic processes, or
pharmacologic responses to a specific therapeutic intervention.
The bill requires the commissioner of insurance to implement
biomarker testing coverage for all individual and group health benefit
plans issued or renewed on or after January 1, 2025.
Biomarker testing is subject to the health benefit plan's annual
deductibles, copayment, or coinsurance but is not subject to any annual
or lifetime maximum benefit limit.
If a carrier requires prior authorization for biomarker testing, the
bill requires the carrier to use an expedited prior authorization process.
Subject to federal authorization and federal financial participation,
beginning July 1, 2024, the bill includes coverage for biomarker testing
as part of the state medical assistance program if the testing is supported
by medical and scientific evidence.
Under the state medical assistance program, the bill requires an
expedited utilization review and prior authorization process, as well as an
appeal process if biomarker testing is denied.

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with Amendments
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