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Health Insurance State Laws:
Biomarker Testing

This chart highlights the state laws related to health insurance coverage of biomarker testing, including states that require coverage, and states with proposed legislation. Check back often, as this chart is updated frequently.

If you don't find what you're looking for, see our other Charts of Health Insurance State Laws:

For more information, see our Checklist: Biomarker Testing, and our Health Insurance Materials & Resources.

StateState Law Requiring Insurance Coverage of Biomarker TestingProposed Legislation Requiring Insurance Coverage of Biomarker Testing
ALABAMA
ALASKA
ARIZONAAriz. HB 2144. Bill signed into law May 6, 2022; law in effect and will be statutorily codified January 1, 2023. The law will provide 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 will be 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).https://www.azleg.gov/legtext/55leg/2R/laws/0219.htm
ARKANSAS
CALIFORNIACalif. Ins. Code 10123.20. Health insurance policies issued, amended, delivered, or renewed after July 1, 2022, cannot require prior authorization for biomarker testing for: (1) individuals with advanced or metastatic stage 3 or 4 cancer; or (2) cancer progression or recurrence in an individual with advanced or metastatic stage 3 or 4 cancer. It does not cover biomarker testing that is not for an FDA-approved therapy for advanced or metastatic stage 3 or 4 cancer.https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=INS§ionNum=10123.20.&article=1.&highlight=true&keyword=biomarkerCalifornia SB 912. As of July 1, 2022, Bill is currently in committee and California legislative session is not yet over. Bill would provide coverage for biomarker testing (includes whole genome sequencing) for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an individual's disease or condition if the test is supported by medical and scientific evidence, as prescribed. Bill would require insurance coverage in a manner that limits disruptions in care, including the need for multiple biopsies or biospecimen samples.https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220SB912&version=20210SB91298AMD
COLORADO
CONNECTICUT
DELAWARE
*DISTRICT OF COLUMBIA
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOISPublic Act 102-0203 (to be codified at 215 ILCS 5/356z.43). 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.https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=102-0203
INDIANA
IOWAHR 6. No proposed legislation related to biomarker insurance coverage in Iowa. However, in 2022 HR 6 declared March as "Precision Medicine and Biomarker Testing Awareness Month."https://www.legis.iowa.gov/legislation/BillBook?ga=89&ba=HR%206
KANSAS
KENTUCKY
LOUISIANALouisiana Rev. Stat. 22:1028.3. Any health coverage plan renewed, delivered, or issued for delivery in Louisiana shall include coverage, subject to deductibles, coinsurance, and copayment, for genetic or molecular testing for cancer including but not limited to tumor mutation testing, next generation sequencing, hereditary germline mutation testing, pharmacogenomic testing, whole exome and genome sequencing, and biomarker testing.http://www.legis.la.gov/legis/Law.aspx?d=1240069
MAINE
MARYLAND
MASSACHUSETTSH. 1137; As of July 1, 2022, Bill is currently in committee and Massachusetts legislative session is not yet over. Bill would provide that insurers could not require prior authorization for biomarker testing for an individual with advanced or metastatic stage 3 or 4 cancer, including testing for cancer progression or recurrence.https://malegislature.gov/Bills/192/H1137.pdf
MICHIGAN
MINNESOTASF 5410; Proposed legislation did not pass through committee in 2022 and the legislative session is now over. Bill would have provided for health plan companies to provide coverage for biomarker testing to diagnose, treat, manage, and monitor illness or disease. The bill only covered biomarker testing supported by medical evidence (such as nationally recognized clinical practice guidelines, consensus statements, FDA labeling, and CMS national coverage determinations).https://www.revisor.mn.gov/bills/text.php?number=SF4610&version=latest&session=ls92&session_year=2022&session_number=0
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIREHB 1290. New Hampshire has not yet proposed legislation related to insurance coverage of biomarker testing, however the state did try to establish a task force on precision medicine, including biomarkers.
NEW JERSEY
NEW MEXICO
NEW YORKSB8147; Proposed legislation still in committee, labeled active as of July 1, 2022, though the 2022 New York Legislative session is over. Bill would require insurance policies to cover biomarker testing for the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of an individual's disease or condition when the test is supported by medical and scientific evidence.https://legislation.nysenate.gov/pdf/bills/2021/S8147
NORTH CAROLINA
NORTH DAKOTA
OHIOHB 608; As of July 1, 2022, Bill is currently in committee and Massachusetts legislative session is not yet over. Bill would require biomarker testing to be covered for diagnosis, treatment and appropriate management of a disease or condition, or ongoing monitoring. The biomarker test must be supported by medical and scientific evidence. The bill would require insurance coverage in a manner that limits disruption of care.https://search-prod.lis.state.oh.us/solarapi/v1/general_assembly_134/bills/hb608/RCH/02/hb608_02_RCH?format=pdf
OKLAHOMA
OREGON
PENNSYLVANIA
*PUERTO RICO
RHODE ISLANDRI H7587. Law passed 6/27/2022 (to be codified at RI Stat. 27-18-89); provisions in effect on January 1, 2024. Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy in Rhode Island shall provide coverage for the services of biomarker testing under each health insurer's respective principles and mechanisms of reimbursement, credentialing, and contracting. Biomarker testing must be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition to guide treatment decisions, and only when the test provides clinical utility as demonstrated by medical and scientific evidence.http://webserver.rilin.state.ri.us/PublicLaws/law22/law22152.htm
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTONRev. Code Wash 48.43.XX (to be codified); Session Law Chapter 123, Laws of 2022 Engrossed Substitute HB 1689 coverage effective January 1, 2023. Law requires health plans issued or renewed on or after January 1, 2023, to exempt enrollees from prior authorization requirements for coverage of biomarker testing for either: (1) stage 3 or 4 cancer, or (2) recurrent, relapsed, refractory, or metastatic cancer. The testing must be a covered service, recommended in nationally recognized guidelines or biomarker compendia, approved by the FDA or otherwise validated, and be prescribed by an in-network provider.https://lawfilesext.leg.wa.gov/biennium/2021-22/Pdf/Bills/Session%20Laws/House/1689-S.SL.pdf?q=20220701105926
WEST VIRGINIA
WISCONSIN
WYOMING
GUAM
LAST UPDATED7/1/227/1/22