Bill > H1368

This bill requires the Executive Office of Health and Human Services and MassHealth to provide coverage for rapid whole genome sequencing (WGS) for Medicaid beneficiaries under 22 years old with complex or acute illnesses of unknown origin. Rapid WGS is defined as a comprehensive genetic investigation that returns preliminary results within 5 days and final results within 14 days, including patient-only, duo, and trio sequencing. The bill specifies detailed clinical criteria for eligibility, such as symptoms involving multiple organ systems, abnormal laboratory tests, refractory seizures, genetic history, and other complex medical conditions that suggest a potential genetic cause. The genetic data generated will be used primarily to assist healthcare professionals in diagnosing and treating patients and will be protected under HIPAA and related health information privacy regulations. The Executive Office of Health and Human Services is authorized to take necessary administrative actions to implement this coverage, including creating new rules, submitting waiver applications to the Centers for Medicare and Medicaid Services, and ensuring federal financial participation. The bill will take effect immediately upon passage.