The proposed bill, HB2470, mandates that the Arizona Health Care Cost Containment System (AHCCCS) provide coverage for rapid whole genome sequencing as a separately payable service for eligible members under specific conditions. These conditions include being under one year of age, having a complex or acute illness of unknown origin, and receiving inpatient care in an intensive care unit or high acuity pediatric care unit. The bill also outlines that coverage may be subject to evidence-based medical necessity criteria, which include the need for multiple genetic tests and timely identification of a molecular diagnosis.

Additionally, the bill defines rapid whole genome sequencing, stipulating that it involves analyzing the entire human genome and returning preliminary results within five days and final results within fourteen days. It emphasizes that the genetic data generated must primarily assist healthcare professionals in diagnosing and treating patients and must comply with privacy regulations under HIPAA. The AHCCCS Director is tasked with submitting necessary applications for CMS approval and may adopt rules to implement this coverage. This bill introduces new provisions to current law, expanding the scope of covered services under AHCCCS.

Statutes affected:
Introduced Version: 36-2907.16
House Engrossed Version: 36-2907.16