Bill > S3098

This bill requires various health insurance providers in New Jersey, including hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, health maintenance organizations, and state health benefit plans, to provide coverage for biomarker precision medical testing. A biomarker is a measurable characteristic that indicates biological processes, pathogenic conditions, or responses to medical interventions, such as gene mutations or protein expressions. Biomarker precision medical testing involves analyzing tissue, blood, or other biospecimens and can include single-analyte tests, multiplex panel tests, and various types of genetic sequencing. The bill mandates that this testing be covered for diagnosing, treating, managing, or monitoring a disease or condition, specifically to guide treatment decisions, and excludes asymptomatic screening. Coverage will be provided when the testing is recognized by FDA-approved test indications, FDA-approved drug tests, FDA drug label warnings, Medicare coverage determinations, or nationally-recognized clinical practice guidelines. The bill ensures that patients and healthcare providers have clear information about appeals processes, limits disruption to patient care, and requires that these benefits be provided with the same considerations as other medical services, including copayments and utilization review. For Medicaid recipients, the testing will be provided with no cost-sharing. The act will take effect 90 days after enactment and apply to policies and contracts issued or renewed after that date.

Budget and Finance, Business and Industry

https://www.njleg.state.nj.us/bill-search/2024/S3098