Bill > SB0435

This bill requires health insurance providers in Tennessee, including TennCare (the state's Medicaid program), to cover biomarker testing starting January 1, 2026. Biomarker testing is defined as the analysis of a patient's tissue, blood, or other biospecimen to identify characteristics that indicate normal or abnormal biological processes, such as gene mutations or protein expressions. The bill mandates that health insurers cover these tests when they are supported by medical and scientific evidence, including FDA-approved test indications, drug-related warnings, Medicare coverage determinations, and recognized clinical practice guidelines. The bill also establishes specific requirements for how insurers must handle these tests, including limiting disruptions in patient care, processing prior authorization requests quickly (within 24-72 hours depending on urgency), and providing a clear, accessible process for patients and healthcare providers to request exceptions to coverage policies. Additionally, the bill authorizes the Tennessee Commissioner of Commerce and Insurance to create rules implementing the biomarker testing coverage requirements, and gives the TennCare director the ability to seek federal waivers necessary to implement the law.

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https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=SB0435&ga=114