New Law Requires Coverage of Biomarker Testing

Recently, Gov. Kemp signed House Bill 85 into law. Under the new law, health benefit policies must cover testing for biomarkers, such as gene mutations or known gene-drug interactions, if supported by medical and scientific evidence to diagnose or treat an insured’s disease or condition. The law also requires insurers to approve or deny preauthorization requests for biomarker testing within specified timeframes and to provide a process for covered individuals to request exceptions to coverage policies or adverse determinations. The coverage requirements apply to individual or group plans or policies providing major medical benefits that are issued, delivered or renewed in the state on or after July 1, 2023.

Employers that sponsor insured plans should be aware of the new coverage requirements and may want to contact their carrier for further information.

HB 85 »