Bill > HB0484

This bill requires both private health insurance plans and TennCare (Tennessee'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 pathogenic biological processes, including gene mutations and protein expression. The bill mandates that health insurers provide coverage for biomarker testing when it is used for diagnosis, treatment, management, or monitoring of a patient's condition, and the test is supported by scientific evidence such as FDA-approved test indications, drug labels, Medicare coverage determinations, or recognized clinical practice guidelines. The bill also stipulates that prior authorization requests for biomarker testing must be processed quickly (within 72 hours for non-urgent and 24 hours for urgent requests) and that patients and healthcare providers must have a clear process to request exceptions to coverage policies. Additionally, the Tennessee insurance commissioner is authorized to create rules to implement the bill, and the bill takes effect immediately upon becoming law.

Budget and Finance, Business and Industry, Government Affairs

https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB0484&ga=114