Recently, two healthcare bills were enacted into law.
Act 316 (previously HB 1035) mandates that insurance policies cover screening for depression of birth mothers. Specifically, Act 316 requires a healthcare insurer that offers, issues, or renews a health benefit plan in the state to provide coverage for depression screening of a birth mother by a healthcare professional within the first six weeks of the mother giving birth on or after January 1, 2024. For this purpose, a healthcare insurer includes but is not limited to, an insurance company, a health maintenance organization and a self-insured governmental or church plan in the state.
Act 429 (previously HB 1121) concerns coverage for biomarker testing for cancer diagnosis and treatment. Specifically, Act 429 requires a health benefit plan that is offered, issued, or renewed in the state to provide coverage for biomarker testing, including for the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of a participant's disease or condition, when the biomarker test is supported by medical and scientific evidence. If prior authorization is required for biomarker testing, Act 429 requires that the utilization review entity approve or deny a prior authorization request within 72 hours for nonurgent healthcare services and within 24 hours for urgent healthcare services.
Employers should be aware of these new laws and may want to contact their carrier for further information.
Act 316 » Act 429 »
PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.
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