CO HB1110

All individual and group health benefit plans issued or renewed in Colorado on or after January 1, 2025 must provide coverage for biomarker testing when supported by medical and scientific evidence, including FDA-approved tests, indicated tests for FDA-approved drugs, and nationally recognized clinical practice guidelines.

Biomarker testing coverage is subject to plan deductibles, copayments, and coinsurance but is not subject to annual or lifetime maximum benefit limits.

Health insurance carriers requiring prior authorization for biomarker testing must approve or deny requests and notify the covered person and provider within 72 hours for non-urgent services or within 24 hours for urgent health-care services.

Subject to federal authorization and financial participation, the state medical assistance program must include biomarker testing coverage beginning July 1, 2024, with expedited utilization review and prior authorization processes and an accessible appeal process if testing is denied.

The bill defines biomarker testing as analysis of a patient's tissue, blood, or biospecimen for indicators of normal or pathogenic biological processes and includes single-analyte tests, multiplex panel tests, and whole genome sequencing.