Biomarker Testing – Enacted Legislation

Biomarkers testing can be used to identify genes, proteins, or other substances that provide information about a person’s cancer. This testing provides important information that can help health care providers select and monitor appropriate treatments, which helps providers develop a more personalized treatment plan for patients. However, both public and private health plans do not provide consistent coverage for biomarker testing. Further, health plans often impose burdensome prior authorization protocols on biomarker testing that can impair or delay patients’ access to their biomarker information. Therefore, states have begun introducing legislation that would require health plans to cover biomarker testing and limit how health plans can impose prior authorization on biomarker testing. The map below contains state-specific information about legislation that has been passed to either require health plans to cover biomarker testing or place guardrails on prior authorization policies for biomarker testing.

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