This bill mandates that health insurance carriers and Medicaid managed care organizations provide reimbursement for clinical laboratory services regardless of whether the laboratory is a participating provider in the managed care plan. Specifically, it requires that payment for these services be made at the same rate as that for participating clinical laboratories for comparable services. Additionally, both carriers and managed care organizations retain the right to review the services provided for medical necessity.

Furthermore, the bill prohibits the Division of Medical Assistance and Health Services in the Department of Human Services from requiring licensed clinical laboratories to participate in the managed care delivery system or transition from a fee-for-service model to a managed care model in order to receive Medicaid reimbursement. This legislation aims to ensure that clinical laboratories are fairly compensated for their services, thereby enhancing access to necessary laboratory testing for patients. The act will take effect 180 days after enactment and will apply to health benefits plans and contracts entered into or renewed after that date.