OR HB3421

Health insurance policies and health care service contracts that reimburse laboratory services must cover biomarker testing prescribed for diagnosis, treatment, management, or ongoing monitoring of a patient's disease or condition

Biomarker testing coverage is required when supported by FDA-approved test indications, FDA-approved drug indications, FDA drug label warnings, CMS National or Local Coverage Determinations, or nationally recognized clinical practice guidelines and consensus statements

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

Oregon Health Authority and coordinated care organizations must provide biomarker testing services and utilization review to medical assistance (Medicaid/OHP) recipients

Requirements apply to policies offered, renewed, or extended on or after the effective date, and to coordinated care organization contracts for periods beginning on or after the effective date