Bill > SB120

This bill mandates that health insurance policies in Delaware must cover biomarker testing, which is the analysis of a person's tissue, blood, or other biological samples for specific characteristics (biomarkers) that indicate biological processes or how a drug might work, to help guide treatment decisions for diagnosed diseases or conditions. This coverage is required when the testing is deemed "medically necessary," meaning it's essential for the patient's health and supported by scientific evidence, such as FDA-approved test indications, drug labels, or nationally recognized clinical guidelines. The bill defines "biomarker" as an objectively measurable characteristic, "biomarker testing" as the analysis of biospecimens, and "nationally recognized clinical practice guideline" as evidence-based recommendations from medical organizations. It clarifies that such covered biomarker tests will not be considered experimental or investigational, and insurers must ensure coverage minimizes disruptions like requiring multiple biopsies. However, this mandate does not apply to certain limited benefit policies, nor does it require coverage for screening purposes or for tests still considered investigational or experimental. The provisions will take effect for policies issued, renewed, or modified after December 31, 2027.