CA SB496

Requires health care service plans and health insurance policies issued, amended, or renewed on or after July 1, 2024, to cover medically necessary biomarker testing (including whole genome sequencing) for diagnosis, treatment, management, or monitoring of disease to guide treatment decisions.

Coverage applies to biomarker tests meeting criteria including FDA approval or clearance, national or local Medicare coverage determinations, evidence-based clinical practice guidelines, or National Academy of Medicine standards.

Prohibits coverage requirements for biomarker testing used solely for screening purposes unless otherwise required by law.

Expands Medi-Cal to include biomarker testing as a covered benefit by July 1, 2024, subject to federal financial participation and necessary federal approvals.

Subjects restricted or denied biomarker testing to state and federal grievance and appeal processes, and requires testing be provided in manner limiting disruption to care, including minimizing need for multiple biopsies.