WA HB1062

Health plans issued or renewed on or after January 1, 2026 must cover biomarker testing for diagnosis, treatment, management, or ongoing monitoring of disease when supported by FDA-approved indications, CMS coverage determinations, nationally recognized clinical practice guidelines, or consensus statements.

Coverage requirements apply to three groups: private health carriers (chapter 48.43 RCW), public employee health plans (chapter 41.05 RCW), and Medicaid recipients through the Health Care Authority (chapter 74.09 RCW).

Biomarker testing includes single-analyte tests, multiplex panel tests, and whole genome sequencing that analyze tissue, blood, or other biospecimens for gene mutations, protein expression, or other biological indicators.

Health carriers must provide coverage in a manner that limits disruptions in care, including avoiding the need for multiple biopsies or biospecimen samples.

The Health Care Authority must seek federal financial participation under Medicaid (Title XIX) or other federal funding sources for biomarker testing coverage.