NC H567

Requires health benefit plans to cover biomarker testing for diagnosis, treatment, care management, and ongoing monitoring when supported by medical and scientific evidence, including FDA-approved tests, Medicare coverage determinations, and nationally recognized clinical practice guidelines

Defines biomarker testing to include analysis of tissue, blood, or other biospecimens through single-analyte tests, multi-plex panel tests, protein expression analysis, and whole exome, genome, and transcriptome sequencing

Prohibits insurers from raising premiums, refusing coverage, or charging higher rates based on genetic or biomarker information obtained about an individual

Extends biomarker testing coverage requirements to the State Health Plan (effective October 1, 2025, at the start of the next plan year) and to Medicaid through laboratory services clinical coverage policies 1S-1 through 1S-13

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