HB 1576 Summary

• Oklahoma Health Care Authority shall cover rapid whole genome sequencing as a separately payable Medicaid service for beneficiaries under 21 years of age with complex or acute illness of unknown etiology while receiving intensive or high acuity hospital care.

• Rapid whole genome sequencing is defined as investigation of the entire human genome returning preliminary results within 7 days and final results within 15-21 days, including patient-only and duo/trio sequencing with biological parents.

• Coverage requires evidence-based medical necessity criteria including symptoms suggesting broad differential diagnosis, provider determination that molecular diagnosis is necessary for clinical decision-making, and specific conditions such as congenital anomalies, abnormal laboratory tests, refractory seizures, or cardiac abnormalities.

• Genetic data generated from sequencing is protected under HIPAA and may be used in scientific research only with express patient or guardian consent; patients may rescind consent at any time and require data expungement.

• Chief Operating Officer of Oklahoma Health Care Authority may promulgate rules, submit waiver applications to Centers for Medicare and Medicaid Services, and take other administrative actions necessary for implementation; act becomes effective July 1, 2025.