This bill requires all health insurance policies, including those from hospital service corporations, medical service corporations, health maintenance organizations, and individual and group health insurance policies, to provide coverage for biomarker testing. Biomarker testing is defined as the analysis of biological samples to identify specific biomarkers that indicate normal biological processes, disease conditions, or responses to therapeutic interventions. Coverage is mandated for diagnosis, treatment, management, or monitoring of diseases when supported by medical and scientific evidence, such as FDA-approved tests and clinical guidelines. The bill also specifies that health insurers must cover biomarker testing without any cost-sharing for individuals, particularly under the Medicaid program.

Additionally, the bill establishes strict timelines for prior authorization requests related to biomarker testing, requiring decisions to be made within 72 hours for non-urgent requests and 24 hours for urgent requests. It ensures that covered individuals and their healthcare providers have access to clear information regarding the appeals process for any adverse determinations. The provisions aim to enhance patient care by minimizing disruptions in the testing process, such as unnecessary biopsies, and the act is set to take effect 90 days after enactment, applying to policies and contracts issued or renewed thereafter.