The bill, introduced by Representative White, aims to enact sections 3902.65 and 5164.13 of the Revised Code, mandating health benefit plans and the Medicaid program in Ohio to cover biomarker testing. The legislation defines "biomarker" and "biomarker testing," and specifies that coverage must be provided for diagnosis, treatment, and ongoing monitoring of diseases or conditions when deemed medically necessary by a qualified healthcare provider. The bill outlines the criteria for medical necessity, which includes support from medical or scientific evidence, FDA approvals, and nationally recognized clinical practice guidelines.

Additionally, the bill emphasizes the importance of ensuring that coverage for biomarker testing does not disrupt patient care, particularly by minimizing the need for multiple biopsies or biospecimen samples. It establishes an accessible appeal process for coverage determinations and clarifies that the bill does not require coverage for screening purposes. The intent of the General Assembly is to improve health outcomes and achieve long-term healthcare cost savings for Ohioans while preventing significant price increases for biomarker tests due to the new coverage requirements.