Substitute Bill No. 6771 mandates that health insurance policies in Connecticut provide coverage for biomarker testing starting January 1, 2026. Biomarker testing is defined as the analysis of a patient's tissue, blood, or other biospecimens to identify specific biomarkers that indicate biological processes or responses to treatments. The bill requires that coverage for such testing be contingent upon demonstrating clinical utility through established medical and scientific evidence, including tests approved by the FDA, Medicare coverage determinations, or adherence to recognized clinical practice guidelines.

Additionally, the bill introduces new provisions regarding the prior authorization process for health insurance coverage. It mandates that insurance entities establish a clear process for insured individuals to appeal adverse utilization review determinations, which must be publicly accessible on their websites. If prior authorization is required, insurers must respond to requests within seven days for non-urgent cases or within seventy-two hours for urgent cases. The bill also requires the Insurance Commissioner, in collaboration with the Commissioner of Public Health, to conduct an annual study on the impact of these provisions on the insurance industry and healthcare services, with reports due from January 1, 2027, to January 1, 2031.