This bill requires that all health insurance policies in New Jersey, including those from hospital service corporations, medical service corporations, health service corporations, and health maintenance organizations, provide coverage for biomarker precision medical testing. This testing involves analyzing tissue, blood, or other biospecimens to identify biomarkers that indicate biological processes or responses to treatments. Coverage is mandated for the diagnosis, treatment, management, or monitoring of diseases, but does not include asymptomatic screening. The testing must be supported by recognized medical evidence, such as FDA approvals and clinical practice guidelines. The bill also clarifies definitions related to biomarker testing and removes references to consensus statements, favoring nationally recognized clinical practice guidelines instead.

Furthermore, the bill stipulates that if a utilization review is necessary, insurers must follow specific guidelines and timeframes for decision-making. It ensures that the benefits for biomarker precision medical testing are equivalent to those for any other medical condition, including applicable copayment, deductible, and coinsurance provisions. The legislation also mandates that individuals under the Medicaid program receive this coverage without cost-sharing. Additionally, it emphasizes the importance of providing clear information to enrollees and healthcare providers regarding the appeals process for adverse determinations related to biomarker testing. The act will take effect 90 days after enactment and will apply to policies and contracts issued or renewed thereafter.