This chart highlights the state laws related to health insurance coverage of biomarker testing. Check back often, as this chart is updated frequently.
If you have a self-funded plan, certain state laws may not apply. For information on how to determine if your plan is self-funded, see our blog post.
For more health insurance information, visit our Health Insurance Materials & Resources.
| State | Has State Laws Requiring Insurance Coverage of Biomarker Tests | State Law Description | Type(s) of biomarker testing covered | Specific population(s) to be tested | Testing Purpose (e.g., screening, diagnosis, treatment, and/or monitoring) | Entities covered by the law (e.g., health plans, employers, labs, etc) | State Medicaid Program Required Coverage of Biomarker Tests | State Laws that require insurance companies to cover laboratory tests to determine thelikelihood of response to specific cancer drugs. | State Laws that require insurance companies to pay for FDA-approved drugs if theyare listed in applicable medical compendia or there is other appropriate medical evdience to support the use of the drug in care. | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALABAMA | X | https://law.justia.com/codes/alabama/title-27/chapter-1/section-27-1-10-1/ | ||||||||||||
| ALASKA | ||||||||||||||
| ARIZONA | AZ Rev Stat § 20-1406.10 (2022) | https://www.azleg.gov/legtext/55leg/2R/bills/HB2144H.htm | The law provides for coverage of biomarker testing from hospital and medical service corporations, health care service organizations, disability insurers, group/blanket disability insurers, and the Arizona Health Care Cost Containment System (AHCCCS). Biomarker testing is covered for purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an insured's disease or condition to guide treatment as long as the test provides clinical utility as demonstrated by medical and scientific evidence (such as FDA-labeled tests, CMS national coverage determinations, nationally-recognized clinical practice guidelines). | Includes single-analyte tests, multiplex panel tests, and whole genome sequencing. | For the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of an individual’s disease or condition to guide treatment decisions. | A hospital service corporation or medical service corporation that issues, amends, delivers, or renews a subscription contract on or after January 1, 2023, shall provide coverage for biomarker testing. | A hospital service corporation or medical service corporation must ensure that coverage is provided in a manner that limits disruption in care, including the need for multiple biopsies or biospecimen samples. | X | https://www.azleg.gov/viewdocument/?docName=https://www.azleg.gov/ars/36/02907-03.htm | X | https://law.justia.com/codes/arizona/title-20/section-20-2326/#:~:text=Any%20health%20benefits%20plan%20that,4. | |||
| ARKANSAS | Arkansas HB 1121 was signed into law on 4/4/2023 as Act 429 | https://www.arkleg.state.ar.us/Home/FTPDocument?path=%2FACTS%2F2023R%2FPublic%2FACT429.pdf | Health benfit plans offered, issued, or renewed in Arkansas must provide coverage for biomarker testing. | Analysis of a patient's tissue, blood, or other biospecimen for the presence of a biomarker, incluidng single-analyte tests, multiplex panel tests, protein expression, and whole exome, whole genome, and whole transcriptome sequencing. | For the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of an individual's disease or condition to guide treatment decisions. | An individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan | X | https://arkleg.state.ar.us/Home/FTPDocument?path=%2FACTS%2F2021R%2FPublic%2FACT779.pdf | X | https://law.justia.com/codes/arkansas/title-23/subtitle-3/chapter-79/subchapter-1/section-23-79-147/ | ||||
| CALIFORNIA | Cal. Health & Safety Code 1367.667 | https://legiscan.com/CA/text/SB496/2023 | Requires health insurance coverage for medically necessary biomarker testing, subject to utilization review management | Analysis of an individual's tissue, blood, or other biospecimen for the presence of a biomarker. It includes, but is not limited to, single-analyte tests, multiplex panel tests, and whole genome sequencing | For the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of an individual’s disease or condition to guide treatment decisions | A health care service plan contract or health insurance policy that is issued, amended, delivered, or renewed on or after July 1, 2024 | Grievance & appeal processes under state and federal law. | X | https://legiscan.com/CA/text/SB496/2023 | X | https://legiscan.com/CA/text/SB496/2023 | |||
| COLORADO | SB24-124 | https://leg.colorado.gov/bills/sb24-124 | All large group health benefit plansand, to the extent that such coverage is not in addition to thebenefits provided pursuant to the benchmark plan, all individualand small group health benefit plans, shall provide coverage forbiomarker testing | Analysis of an individual's tissue, blood, or other biospecimen for the presence of a biomarker. It includes single-analyte tests, multiplex panel tests, protein expression, and whole exome, whole genome, and whole transcriptome sequencing | For diagnosis, treatment, appropriate management, and ongoing monitoring of an individual's disease or condition to guide treatment decisions. | All large group health benefit plans and, to the extent that such coverage is not in addition to the benefits provided pursuant to the benchmark plan, all individual and small group health benefit plans | X | https://leg.colorado.gov/sites/default/files/2022a_1264_signed.pdf | ||||||
| CONNECTICUT | Public Act No. 25-16 | https://www.cga.ct.gov/2025/ACT/PA/PDF/2025PA-00016-R00HB-06771-PA.PDF | Effective January 1, 2026, requires coverage for biomarker testing for the purpose of diagnosis, treatment, appropriate management or ongoing monitoring of an insured's disease or condition. | Analysis of an individual's tissue, blood or other biospecimen for the presnce of a biomarker, including, but not limited to, tests for a single substance, tests for multiple substances, diseases or conditions. | For dianosis, treatment, appropriate management or ongoing monitoring of a disease or condition. | Individual and group health insurance policies. | Public Act No. 24-50 | https://www.cga.ct.gov/2024/ACT/PA/PDF/2024PA-00050-R00SB-00307-PA.PDF | x | https://law.justia.com/codes/connecticut/title-38a/chapter-700c/section-38a-492b/ | ||||
| DELAWARE | Del. Code Ann. tit. 18, § 3337(a) and Del. Code Ann. tit. 18, § 3554(a) | https://legis.delaware.gov/SessionLaws/Chapter?id=21313 | Requires coverage for CA-125 (a biomarker) monitoring of ovarian cancer subsequent to treatment | CA-125 | Individuals with ovarian cancer | Monitoring subsequent to treatment | Individual health, sickness or accident policies, contracts, or certificates, and group and blanket health insurance policies | X | https://law.justia.com/codes/delaware/title-18/chapter-33/subchapter-i/section-3338b/ | |||||
| FLORIDA | Florida CS/CS/HB 885 | https://www.flsenate.gov/Committees/billsummaries/2024/html/3496 | Requires the Florida Medicaid program and the Division of State Group Insurance program to provide coverage for biomarker testing | Analysis of an individual's tissue, blood, or other biospecimen, including single analyte tests, multiplex panel tests, protein expression, and who exome, whole genome, and whole transcriptome sequencing | For diagnosis, treatment, management, and ongoing monitoring of an individual's disease or condition, to guide treatment decisions | Medicaid and state group insurance programs | x | https://www.flsenate.gov/Committees/billsummaries/2024/html/3496 | x | https://www.flsenate.gov/laws/statutes/2019/627.4239#:~:text=2019%20Florida%20Statutes%20*%20(a)%20Alter%20any,the%20use%20of%20the%20drug%20is%20contraindicated. | ||||
| GEORGIA | Act 232 (amending Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated and Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated) | https://law.justia.com/codes/georgia/title-33/chapter-24/article-1/section-33-24-59-33/ | Effective July 1, 2023, health benefits policies and Medicaid, shall include coverage for biomarker testing for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the testing is supported by medical and scientific evidence. | Includes, but is not limited to, single-analyte tests, multiplex panel tests, whole genome sequencing, protein expression, whole exome, and whole transcriptome. | Diagnosis, treatment, appropriate management, or ongoing monitoring of a disease or condition. | Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, or renewed in this state after July 1, 2023 | X | https://law.justia.com/codes/georgia/title-49/chapter-4/article-7/section-49-4-159-3/ | x | https://law.justia.com/codes/georgia/2022/title-33/chapter-24/article-1/section-33-24-59-11/#:~:text=No%20health%20benefit%20policy%20issued,drug%20list%2C%20if%20any;%20or | ||||
| HAWAII | ||||||||||||||
| IDAHO | ||||||||||||||
| ILLINOIS | Public Act 102-0203 (to be codified at 215 ILCS 5/356z.43). | https://www.ilga.gov/Legislation/BillStatus/FullText?GAID=16&DocNum=1779&DocTypeID=HB&LegId=130484&SessionID=110 | The law requires health insurance plans amended, delivered, issued, or renewed after January 1, 2022, to include coverage for biomarker testing for purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the test is supported by medical and scientific evidence (such as FDA labeling, CMS national coverage determination, nationally recognized clinical practice guidelines, etc.). Coverage and testing shall be conducted in an efficient manner to provide the most complete range of results to the healthcare provider without requiring multiple biopsies, biospecimen samples, or other delays or disruptions in patient care. Law also provides that where biomarker testing is restricted by an insurance plan that there shall be a clear and accessible process to request an exception on the insurer's website. | Includes, but is not limited to, single-analyte tests, multi-plex panel tests, and partial or whole genome sequencing. | Diagnosis, treatment, appropriate management, or ongoing monitoring of a disease or condition when the test is supported by medical and scientific evidence. | A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued or renewed on or after January 1, 2022, shall include coverage for biomarker testing. | X | Illinois General Assembly - Full Text of Public Act 102-0203 | X | https://www.ilga.gov/legislation/ilcs/documents/021500050K356z.7.htm | ||||
| INDIANA | Ind. Code § 27-8-14.3-10 | https://law.justia.com/codes/indiana/title-27/article-8/chapter-14-3/section-27-8-14-3-10/ | Effective July 1, 2024 this law requires health plans to provide coverage for biomarker testing. | A health plan shall provide coverage for biomarker testing for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when biomarker testing is supported by medical and scientific evidence | (1) A policy of accident and sickness insurance.(2) A contract with a health maintenance organization that provides coverage for basic health care services.(3) The Medicaid risk based managed care program operated under IC 12-15.(4) A state employee health plan. | x | https://law.justia.com/codes/indiana/title-27/article-8/chapter-20/section-27-8-20-7/ | |||||||
| IOWA | House File 2668 | https://www.legis.iowa.gov/legislation/BillBook?ba=HF2668&ga=90 | Requires all Iowa-regulated insurance plans to cover biomarker testing for covered individuals. | "Biomarker testing" means the analysis of an individual's tissue, blood, or other biospecimen for the presence of a biomarker, including but not limited to single-analyte tests, multiplex panel tests, or whole genome sequencing. | Diagnosing, treating, appropriately managing, or monitoring a disease or condition. | A policy, contract, or plan proviging for third-party payment or prepayment of medical expenses. | Since July 1, 2013, the CPT Code 86352 “CELLULAR FUNC ASSAY, DETECT OF BIOMRKER” has been covered under the Iowa Medicaid physician fee schedules for MDs and DOs. | https://secureapp.dhs.state.ia.us/MedicaidFeeSched/X02.xml | X | 514C.24 Cancer treatment — coverage.https://www.legis.iowa.gov/docs/code/514C.26.pdf | ||||
| KANSAS | X | https://www.ksrevisor.org/statutes/chapters/ch40/040_002_0184.htmlhttps://www.ksrevisor.org/statutes/chapters/ch40/040_002_0168.html | ||||||||||||
| KENTUCKY | Chapter 77 amends Kentucky Revised Statutes Chapter 304, Section 17-A, New Subsection | https://apps.legislature.ky.gov/recorddocuments/bill/23RS/hb180/bill.pdf | Requires Kentucky health benefit plans & the Department of Medicaid Servicesto provide coverage for biomarker testing. | Includes but is not limited to single-analyte tests, multiplex panel tests,and whole genome sequencing. | Diagnosis, treatment, appropriate management, orongoing monitoring of an insured's disease or condition when the test is supported by medical and scientific evidence. | Health benefit plans | x | https://apps.legislature.ky.gov/recorddocuments/bill/23RS/hb180/bill.pdf | ||||||
| LOUISIANA | Louisiana Rev. Stat. 22:1028.3. | https://legiscan.com/LA/drafts/SB48/2024 | Requires health coverage plans renewed, delivered, or issued for delivery in Louisiana to cover biomarker testing. | Biomarker testing includes but is not limited to single-analyte tests, multi-plex panel tests, protein expression, whole exome, whole genome, and whole transcriptome sequencing. | Diagnosis, treatment, appropriate management, or ongoing monitoring of an individual’s disease or condition when the test is supported by medical and scientific evidence. | Any hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, contract, or other agreement with a health maintenance organization or a preferred provider organization, health and accident insurance policy, or any other insurance contract of this type in Louisiana, including a group insurance plan or self-insurance plan, and the office of group benefits. | X | https://www.legis.la.gov/legis/Law.aspx?d=1296618 | ||||||
| MAINE | X | https://legislature.maine.gov/statutes/24-A/title24-Asec4234-D.html | ||||||||||||
| MARYLAND | Chapter 322 Annotated Code of Maryland Article – Health – General Sections 15–102.3(k), 103(a) | https://legiscan.com/MD/text/HB1217/id/2774309 | Effective July 1, 2025, health insurance plans shall provide coverage for biomarker testing. | Includes single–analytetests, multi–plex panel tests, protein expression, and whole exome,whole genome, and whole transcriptome sequencing. | Diagnosis, treatment, appropriatemanagement, or ongoing monitoring of a disease or condition that issupported by medical and scientific evidence | (1) Insurers and nonprofit health service plans thatprovide hospital, medical, or surgical benefits to individuals or groupson an expense–incurred basis under health insurance policies orcontracts that are issued or delivered in the state; and(2) health maintenance organizations that providehospital, medical, or surgical benefits to individuals or groups undercontracts that are issued or delivered in the state. | X | https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/hb1217?ys=2023RS#:~:text=Requiring%20the%20Maryland%20Medical%20Assistance,establishing%20requirements%20for%20deductibles%2C%20copayments%2C | X | https://law.justia.com/codes/maryland/2020/insurance/title-15/subtitle-8/section-15-827/ | ||||
| MASSACHUSETTS | x | https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section47K#:~:text=No%20individual%20policy%20of%20accident,of%20section%20forty%2Dseven%20L. | ||||||||||||
| MICHIGAN | x | https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-500-3406q | ||||||||||||
| MINNESOTA | Minn. Stat. § 62Q.473Added by 2023 Minn. Laws, ch. 70,s 2-26, eff. 1/1/2025 | https://www.revisor.mn.gov/laws/2023/0/70/laws.2.26.0#laws.2.26.0 | Effective January 1, 2025, health plans must provide coverage for biomarker testing. | Includes single–analyte tests, multi–plex panel tests, protein expression, and whole exome,whole genome, and whole transcriptome sequencing. | Diagnosis, treatment, management, and monitoring illness or disease if the test provides clinical utility, as demonstrated by medical and scientific evidence. | Health plans | x | https://www.revisor.mn.gov/statutes/cite/62Q.525#:~:text=(a)%20Every%20type%20of%20coverage,1%20applies%20to%20other%20drugs. | ||||||
| MISSISSIPPI | X | https://law.justia.com/codes/mississippi/2010/title-83/9/83-9-8 | ||||||||||||
| MISSOURI | x | https://revisor.mo.gov/main/OneSection.aspx?section=376.429&bid=20702 | ||||||||||||
| MONTANA | ||||||||||||||
| NEBRASKA | NE LB77 was signed into law on 6/4/2025; provisions related to biomarker testing will be effective as of 1/1/2028 | https://legiscan.com/NE/text/LB77/id/3252446 | Requires that insurers provide coverage for biomarker testing when the test is used for the diagnosis, treatment, appropriate management, or ongoing monitoring of cancer, an autoimmune or autoinflammatory disease, Parkinson's disease, ALS, Alzheimer's disease and related dementias, rheumatoid arthritis, preeclampsia, sickle cell anemia,l or a cardiovascular condition; an organ or tissue transplant; or pharmacogenomic testing | Includes, but is not limited to, single-analyte tests, multi-plex panel tests, protein expression, and whole exome, whole genome, and whole transcriptome sequencing | Diagnosis, treatment, appropriate management, or ongoing monitoring or cancer, as well as other conditions (See state law description) | Individual or group policies, as well as any self-funded employee benefit plans to the extent not preempted by federal law | No later than 1/1/2028 | https://legiscan.com/NE/text/LB77/id/3252446 | X | https://nebraskalegislature.gov/laws/statutes.php?statute=44-788 | ||||
| NEVADA | NRS 287.010, 287.04335, 422.2717-422.27248, 689A.04033-689A.0465, 689B.0303-689B.0379, 689C.1655-689C.169, 689C.194-689C.195, 689C.425, 695A.184-695A.1875, 695B.1901-695B.1949, 695C.050, 695C.1691-695C.176, 695G.162-695G.177 | https://www.leg.state.nv.us/App/NELIS/REL/82nd2023/Bill/9818/Text# | Requires that insurers that issue policies of health insurance include coverage for medically necessary biomarker testing. | Includes, without limitation, single-analyte tests, multiplex panel tests and whole genome, whole exome and whole transcriptome sequencing. | Diagnosis, treatment, appropriate management and ongoing monitoring of cancer when such biomarker testing is supported by medical and scientific evidence | Insurers that issue policies of health insurance | The director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenditures incurred for medically necessary biomarker testing for the diagnosis, treatment, appropriate management and ongoing monitoring of cancer when such biomarker testing is supported by medical and scientific evidence. | https://www.leg.state.nv.us/App/NELIS/REL/82nd2023/Bill/9818/Text# | X | https://law.justia.com/codes/nevada/chapter-689a/statute-689a-0404/ | ||||
| NEW HAMPSHIRE | x | https://law.justia.com/codes/new-hampshire/2023/title-xxxvii/chapter-415/section-415-6-g/#:~:text=(b)%20As%20a%20condition%20of,the%20drug%20has%20been%20prescribed; | ||||||||||||
| NEW JERSEY | A-4163/S-3098 was signed into law on 4/23/2025 | https://njleg.state.nj.us/bill-search/2024/S3098/bill-text?f=S3500&n=3098_I1 | Requires state-regulated health insurers to cover biomarker testing. | Includes, but Is not limited to, single-analyte tests, multiplex panel tests, protein expression, and whole exome, whole genome, and whole transcriptome sequencing. | Diagnosis, treatment, appropriate management, or ongoing monitoring of a disease or condition when the test is supported by medical and scientific evidence | Hospital service corporation contracts, medical service corporation contracts, health service corporation contracts, individual and group health insurance policies, individual health benefit plans, small employer health benefits plans, health maintenance organization contracts, State Health Commission and School Employees' Health Benefits Commission contracts | x | https://njleg.state.nj.us/bill-search/2024/S3098/bill-text?f=S3500&n=3098_I1 | x | https://law.justia.com/codes/new-jersey/title-26/section-26-1a-36-9/#:~:text=%22Off%2Dlabel%22%20use%20of%20FDA%2Dapproved%20drugs%20provides,to%20obtain%20medically%20effective%20treatment. | ||||
| NEW MEXICO | NMS § 13-7-NEWAdded by 2023, c. 138,s. 1, eff. 6/13/2023 | https://www.nmlegis.gov/Sessions/23%20Regular/final/HB0073.pdf | Effective January 1, 2024, biomarker testing is covered for the purposes of diagnosis, treatment, appropriate management or ongoing monitoring of an insured's disease or condition when the test is supported by medical and scientific evidence. | Includes single-analyte tests, multi-plex panel tests, protein expression and whole exome, whole genome and whole transcriptome sequencing. | Diagnosis, treatment, appropriate management or ongoing monitoring of an insured's disease or condition when the test is supported by medical and scientific evidence | Group health coverage, including self-insurance, offered, issued, amended, delivered or renewed under the Health Care Purchasing Act; A blanket or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state; An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state; An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state | x | https://www.nmlegis.gov/Sessions/23%20Regular/final/HB0073.pdf | x | https://www.srca.nm.gov/parts/title13/13.010.0013.html | ||||
| NEW YORK | Assembly Bill 8502 | https://legiscan.com/NY/text/A08502/id/2869606 | As of 4/1/2024, requires health insurance policies and Medicaid to cover biomarker testing for certain purposes. | Includes, but is not limited to, single-analyte tests and multi-plex panel tests performed at participating in-network laboratory facilities that are either CLIA certified or CLIA waived by the federal food and drug administration. | Diagnosis, treatment, appropriate management, or ongoing monitoring of a person's disease or condition when the test provides clinical utility to the patient as demonstrated by medical and scientific evidence. | Every policy which provides medical, major medical, or similar comprehensive-type coverage; every insurer delivering a group or blanket policy or issuing a group or blanket policy for delivery in this state that provides coverage for medical, major medical, or similar comprehensive-typecoverage; a medical expense indemnity corporation, a hospital service corporation or a health service corporation that provides coverage for medical, major medical, or similar comprehensive-type coverage | x | https://www.nysenate.gov/node/12013563 | x | https://www.nysenate.gov/legislation/laws/ISC/3216 | ||||
| NORTH CAROLINA | X | https://www.ncleg.net/enactedlegislation/statutes/pdf/byarticle/chapter_58/article_67.pdf | ||||||||||||
| NORTH DAKOTA | x | https://ndlegis.gov/cencode/t26-1c36.pdf | ||||||||||||
| OHIO | x | https://codes.ohio.gov/ohio-revised-code/section-1751.66#:~:text=(A)%20No%20individual%20or%20group,human%20services%20under%2042%20U.S.C. | ||||||||||||
| OKLAHOMA | Okla. Stat. tit. 56, § 4003Added by Laws 2023, c. 331,s. 3, eff. 1/1/2024. | http://webserver1.lsb.state.ok.us/cf_pdf/2023-24%20ENR/SB/SB513%20ENR.PDF | As of 1/1/2024, requires health benefit plans, including the Oklahoma Employees Insurance Plan, as well as Medicaid, to provide coverage for biomarker testing. | Includes, but is not limited to, single-analyte tests, multiplex panel tests, gene or protein expression, and whole exome, whole genome, and whole transcriptome sequencing. | Diagnosis, treatment, appropriate management, or ongoing monitoring of someone's disease or condition to guide treatment decisions when the biomarker test provides clinical utility as demonstrated by medical and scientific evidence. | Any health benefit plan, including the Oklahoma EmployeesInsurance Plan that is offered, issued, or renewed on or after 1/1/2024. | X | http://webserver1.lsb.state.ok.us/cf_pdf/2023-24%20ENR/SB/SB513%20ENR.PDF | x | https://www.oid.ok.gov/wp-content/uploads/2019/10/091517_C40S5.pdf | ||||
| OREGON | x | https://oregon.public.law/statutes/ors_743A.062 | ||||||||||||
| PENNSYLVANIA | HB 1754: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage for biomarker testing. | https://legiscan.com/PA/text/HB1754/id/3006427/Pennsylvania-2023-HB1754-Amended.pdf | Effective January 1, 2024, requires insurers to include biomarker testing as a covered benefit. | Includes, but is not limited to, single-analyte tests and multi-plex panels performed at a participating in-network laboratory that is CLIA certified by the federal FDA. | Diagnosis, treatment, appropriate management, or ongoing monitoring of a covered person’s disease or condition to guide treatment decisions. | Insurers that offer, issue, or renew health insurance policies in PA. | As of 1/1/2026 | https://legiscan.com/PA/text/HB1754/id/3006427 | ||||||
| RHODE ISLAND | RI Stat. 27-18-89 | https://legiscan.com/RI/text/S2201/id/2596966 | As of 1/1/2024, requires health insurers, nonprofit hospital service corporations, and health maintenance organizations to issue policies that provide coverage for biomarker testing | Includes, but is not limited to, single-analyte tests, multi-plex panel tests, and whole genome sequencing | Diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee’s disease or condition to guide treatment decisions, when the test provides clinical utility as demonstrated by medical and scientific evidence | Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in RI on or after January 1, 2024 | x | https://eohhs.ri.gov/sites/g/files/xkgbur226/files/2024-03/Biomarker%20Testing%20022224.pdf | X | https://law.justia.com/codes/rhode-island/title-27/chapter-27-55/section-27-55-2/ | ||||
| SOUTH CAROLINA | X | https://law.justia.com/codes/south-carolina/title-38/chapter-71/section-38-71-275/ | ||||||||||||
| SOUTH DAKOTA | x | https://sdlegislature.gov/Statutes/58-17-101 | ||||||||||||
| TENNESSEE | x | https://law.justia.com/codes/tennessee/title-56/chapter-7/part-23/section-56-7-2352/#:~:text=(1)%20No%20insurance%20policy%20or,or%20in%20the%20medical%20literature. | ||||||||||||
| TEXAS | SECTIONA1. Subtitle E, Title 8, Insurance Code, is amendedby adding Chapter 1372 to read as follows:CHAPTER 1372. COVERAGE FOR BIOMARKER TESTINGSec.A1372.001.A | https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1372.htm | Effective 9/1/2023, requires heatlh benefit plans, including Medicaid, to cover biomarker testing | Includes single-analyte tests, multiplex panel tests, and whole genome sequencing | Diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee’s disease or condition to guide treatment when the test is supported by medical and scientific evidence | Sec. 1372.002 provides a lengthy description of the health benefit plans that are covered, including individual and group coverage, Medicaid (including the Medicaid managed care program), and self-funded health benefit plans sponsored by professional employer organizations | x | https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1372.htm | X | https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm | ||||
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| VERMONT | x | https://law.justia.com/codes/vermont/title-8/chapter-107/section-4100e/ | ||||||||||||
| VIRGINIA | x | https://legacylis.virginia.gov/cgi-bin/legp604.exe?971+sum+SB1164 | ||||||||||||
| WASHINGTON | X | https://app.leg.wa.gov/wac/default.aspx?cite=284-30-450 | ||||||||||||
| WEST VIRGINIA | x | https://code.wvlegislature.gov/33-15-4C/ | x | |||||||||||
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| LAST UPDATED | 8/5/2025 | 7/3/2025 | 7/3/2025 | 7/3/2025 | 7/3/2025 | 7/3/2025 | 7/3/2025 | 7/3/2025 | 7/3/2025 | 7/3/2025 |