Bill > H1335

This bill aims to enhance biomarker testing services within Florida's Medicaid program by establishing clearer definitions and coverage requirements. The bill defines "biomarker" as a measurable characteristic indicating biological processes or responses, and "biomarker testing" as an analysis of patient tissue or blood samples using specific laboratory testing codes. By August 2025, the Agency for Health Care Administration must create a reimbursement schedule and billing codes for biomarker testing, and Medicaid managed care plans must provide coverage for such testing at the same scope and frequency as other medically necessary treatments. Notably, the bill specifically authorizes Medicaid to cover blood-based biomarker tests for colorectal cancer screening. Additionally, the agency is required to commission an independent, five-year cost-benefit analysis of these blood-based tests, examining factors such as test utilization, treatment costs, potential cost avoidance, and patient outcomes. The agency must submit interim and final reports on this analysis to state leadership by November 2028 and November 2030, respectively. The provisions related to biomarker testing and colorectal cancer screening are set to be automatically repealed on July 1, 2031, unless the Legislature specifically reenacts them.

Budget and Finance, Health and Social Services

Health Care Facilities & Systems Subcommittee (H)

https://www.flsenate.gov/Session/Bill/2025/1335