CT HB06628

Requires the Commissioner of Social Services to provide Medicaid coverage for biomarker testing used for diagnosis, treatment, management, or ongoing monitoring of a patient's disease or condition, effective July 1, 2023

Coverage must be supported by medical and scientific evidence, including FDA approval, FDA drug label recommendations, Medicare national or local coverage determinations, or nationally recognized clinical practice guidelines and consensus statements

Biomarker testing includes analysis of tissue, blood, or other biospecimens for gene mutations, protein expressions, or other measurable characteristics, including single-substance tests, multi-substance tests, and whole genome sequencing

Commissioner must provide online access for Medicaid enrollees and providers to request exceptions to prior authorization requirements or other coverage policies for biomarker testing

Coverage is contingent on permissibility under federal law