HI HB553

Requires health insurers, mutual benefit societies, health maintenance organizations, and Medicaid managed care plans to cover biomarker testing for diagnosis, treatment, management, and ongoing monitoring of diseases beginning January 1, 2026

Biomarker testing coverage must be supported by FDA-approved indications, Medicare coverage determinations, or nationally recognized clinical practice guidelines and consensus statements

Coverage must be provided in a manner that limits disruptions in care, including avoiding the need for multiple biopsies, with copayments and deductibles no less favorable than for other medical services

Insurers must provide patients and healthcare providers with a clear, accessible exception request process when coverage is restricted, available on the insurer's website

Insurers must send written notice to policyholders about the new biomarker testing coverage by December 31, 2026