The bill aims to improve patient access to biomarker testing, which is essential for diagnosing and managing various medical conditions. It amends several chapters of the General Laws to ensure that biomarker testing is covered under health insurance policies for active and retired employees of the Commonwealth, Medicaid recipients, and individuals with private insurance. Key terms such as "biomarker," "biomarker testing," and "nationally recognized clinical practice guidelines" are defined to establish a framework for acceptable testing and coverage criteria. Coverage is mandated when supported by medical evidence, including FDA-approved tests and guidelines from recognized medical organizations, with an emphasis on minimizing disruptions in patient care.

Furthermore, the bill amends Chapter 176G of the General Laws to require health maintenance contracts to cover biomarker testing, specifying that prior authorization requests must be processed within strict timelines—72 hours for standard requests and 24 hours if a delay poses a significant health risk. If no response is received within these timeframes, the request is automatically granted. The legislation also ensures that patients and healthcare providers have clear access to processes for requesting exceptions to coverage policies, which must be prominently outlined on the carrier's website. Overall, the bill seeks to enhance patient outcomes by facilitating timely access to necessary diagnostic tools.