MN HF4899

Health plan companies must provide coverage for biomarker testing to diagnose, treat, manage, and monitor illness or disease.

Coverage is required only when testing is supported by medical evidence, including nationally recognized clinical practice guidelines, consensus statements, FDA-approved or FDA-cleared test labels, or Centers for Medicare and Medicaid Services coverage determinations.

Coverage must be provided in a manner that limits care disruption, including minimizing the need for multiple biopsies or biospecimen samples.

Medical assistance (Medicaid) must cover biomarker testing under the same requirements as private health plans under a new subdivision to Minnesota Statutes section 256B.0625.

Requirements are effective January 1, 2023 for health plans offered, issued, or renewed on or after that date, with Medicaid coverage effective upon federal approval.