TAX CREDIT FOR VOLUNTARY PROVISION OF CERTAIN TESTS THROUGH ERISA HEALTH PLANS (Section 135.1270)

This act creates a $500 tax credit for employers who provide health insurance subject to the Employee Retirement Income Security Act of 1974 meeting the requirements of the act applicable to health benefit plans regulated by the state. The tax credit is non-refundable, and the total amount of tax credits authorized shall not exceed $20 million.

MEDICAL TESTING UNDER MO HEALTHNET (Sections 191.300, 191.312, and 208.152)

Under this act, the Department of Health and Senior Services shall offer a public comment period each year to collect comments and information pertaining to best practices in genetically-based newborn screening for pediatric rare diseases. The Department shall also annually seek out information and research updates from prenatal and early childhood genetic screening research organizations. The Department shall compile this information in an annual report to the Governor and General Assembly and shall include any recommendations for any updates for newborn screening.

Additionally, the Department of Social Services shall include coverage of genetic testing for pediatric rare diseases as a covered MO HealthNet service. Rapid whole genome sequencing testing shall be covered in certain inpatient settings, while biomarker testing shall be covered in certain outpatient settings. The Department shall seek any necessary state plan amendments or waivers from the Centers for Medicare and Medicaid Services to implement this provision.

MEDICAL TESTING UNDER HEALTH BENEFIT PLANS (Section 376.1270)

This act requires health benefit plans to provide coverage for biomarker testing, as defined in the act, as well as for rapid whole genome sequencing (rWGS), as defined in the act. The act specifies when the testing shall be covered, includes examples of medical necessity, enacts provisions relating to prior authorization and utilization review for the services, prohibits coverage denials based on the tests being experimental or investigational, specifies that genetic counseling before and after the tests is covered, requires health carriers to maintain on their web sites up-to-date policies on covered genomic and biomarker tests, and requires testing under the act to be performed by a laboratory certified in accordance with federal law.

ERIC VANDER WEERD