VT H0136

Requires health insurance plans and Medicaid to cover biomarker testing for diagnosis, treatment, management, and ongoing monitoring of diseases when supported by medical and scientific evidence

Biomarker testing includes analysis of tissue, blood, or other biospecimens through single-analyte tests, multiplex panel tests, protein expression analysis, and whole exome/genome/transcriptome sequencing

Coverage must be provided when testing is supported by FDA-approved or cleared test indications, FDA-approved drug labels, CMS national or local coverage determinations, or nationally recognized clinical practice guidelines

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

Health insurance provisions take effect January 1, 2026 (with full implementation by January 1, 2027); Medicaid provisions take effect January 1, 2026 or upon CMS approval of any required state plan amendment