NJ A4163

Mandates all health insurance policies, including hospital service corporations, medical service corporations, HMOs, individual and group plans, and state employee plans, to cover biomarker precision medical testing for diagnosis, treatment, management, or monitoring of diseases (excluding asymptomatic screening)

Coverage required when testing is recognized by FDA-approved/cleared test indications, FDA-approved drug indications, FDA drug label warnings, CMS National or Local Coverage Determinations, or nationally recognized clinical practice guidelines

Biomarker precision medical testing includes analysis of tissue, blood, or biospecimens for biomarkers such as gene mutations, protein expression, single-analyte tests, multiplex panels, and whole genome/exome/transcriptome sequencing

Requires utilization review decisions to follow guidelines and timeframes established under P.L.2023, c.296, with clear appeal process information provided to patients and providers

Medicaid recipients must receive biomarker precision medical testing with no cost-sharing, and the law takes effect 90 days after enactment (approved April 23, 2025)