CA SB535

Prohibits health care service plans and health insurers from requiring prior authorization for biomarker testing in enrollees or insureds with advanced or metastatic stage 3 or 4 cancer, effective July 1, 2022.

Prohibits prior authorization requirements for biomarker testing related to cancer progression or recurrence in patients with advanced or metastatic stage 3 or 4 cancer.

Defines "biomarker test" as a diagnostic test of cancer patient biospecimens for DNA or RNA alterations to identify cancer subtypes and guide treatment.

Allows health care service plans and insurers to still require prior authorization for biomarker testing not associated with FDA-approved therapies for advanced or metastatic stage 3 or 4 cancer.

Applies requirements to Medi-Cal managed care plans and does not limit patient rights to biomarker testing through approved clinical trials.