Bill > HB0484

This bill mandates that Tennessee health benefit plans, which are types of health insurance coverage, and TennCare health benefit plans, which are health plans provided through the state's Medicaid program, must cover biomarker testing starting January 1, 2027. Biomarker testing involves analyzing a patient's biological samples, like tissue or blood, to identify specific characteristics (biomarkers) that can indicate normal biological processes, diseases, or how a patient might respond to certain medications. This coverage is required when a healthcare provider orders the test to help diagnose, treat, manage, or monitor a patient's condition, provided the testing is supported by medical and scientific evidence, such as FDA-approved indications, national coverage decisions, or recognized clinical practice guidelines. The bill also aims to ensure this coverage is provided without causing undue disruption to patient care and includes provisions for clear processes for appealing coverage denials. Additionally, the Commissioner of Commerce and Insurance is tasked with reporting on the usage and cost savings of this biomarker testing coverage by February 1, 2029.