NY A01673

Requires health insurance policies (individual and group) and Medicaid to cover biomarker testing for diagnosis, treatment, management, or monitoring of disease or conditions when supported by FDA approval, CMS coverage determinations, or nationally recognized clinical practice guidelines.

Defines biomarker testing as analysis of patient tissue, blood, or other samples performed at CLIA-certified or CLIA-waived laboratories, including single-analyte and multiplex panel tests.

Mandates coverage be provided in a manner that limits disruptions in care, including minimizing the need for multiple biopsies or biospecimen samples.

Requires insurers and Medicaid to provide clear, accessible, and convenient processes for covered persons and prescribing practitioners to request exceptions to coverage policies, made readily available on insurer websites.

Takes effect April 1, 2024 and applies to all policies and contracts issued, renewed, modified, altered, or amended on or after that date.