The bill amends Florida Statutes to enhance the coverage and definition of biomarker testing within the Medicaid program. It revises the definition of "biomarker testing" to include specific types of analyses and establishes that the Agency for Health Care Administration (AHCA) must create a reimbursement schedule and billing codes for these tests by August 1, 2025. Additionally, the bill mandates that Medicaid managed care plans cover medically necessary blood-based biomarker tests for colorectal cancer screening at the same level as other necessary tests. The AHCA is also required to conduct a five-year cost-benefit analysis on the effectiveness of these tests, with interim and final reports due by November 2028 and November 2030, respectively.

Furthermore, the bill specifies that while biomarker testing is not required for screening purposes, the agency may cover medically necessary blood-based tests for colorectal cancer screening. It includes provisions for a clear authorization process for both recipients and providers to request biomarker testing. The amendments to the statutes will be repealed on July 1, 2031, unless reenacted by the Legislature, ensuring a review of the program's effectiveness and necessity.

Statutes affected:
H 1335 Filed: 408.9091
H 1335 c1: 409.9745