MN SF4610

Health plan companies must provide coverage for biomarker testing to diagnose, treat, manage, and monitor illness or disease effective January 1, 2023.

Coverage is required only when biomarker testing is supported by medical evidence including nationally recognized clinical practice guidelines, consensus statements, FDA-approved or FDA-cleared test indications, or Medicare coverage determinations.

Biomarker testing includes single-analyst tests, multiplex panel tests, and whole genome sequencing analysis of tissue, blood, or other biospecimens for the presence of biomarkers such as gene mutations or protein expression.

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

Medical assistance under Minnesota's Statutes section 256B.0625 must cover biomarker testing under the same requirements as health plan companies, effective January 1, 2023, or upon federal approval, whichever is later.