HB1779 Summary

• Adds biomarker testing coverage requirement to Illinois health insurance policies, group and individual accident and health insurance, and managed care plans effective January 1, 2022.

• Defines biomarker testing as analysis of a patient's tissue, blood, or fluid for biomarkers including gene mutations and protein expression, covering single-analyte tests, multi-plex panels, and genomic sequencing.

• Requires coverage when biomarker testing is supported by medical and scientific evidence including FDA approvals, Medicare coverage determinations, clinical practice guidelines, professional society recommendations, and peer-reviewed literature.

• Mandates efficient testing without requiring multiple biopsies or biospecimen samples, and establishes clear exception request processes for patients and prescribing practitioners when coverage is restricted.

• Applies biomarker testing coverage requirements to state employees, counties, municipalities, school districts, Medicaid, health maintenance organizations, limited health service organizations, and voluntary health service plans.