The bill proposes the enactment of sections 3902.65 and 5164.13 of the Revised Code, mandating that health benefit plans and the Medicaid program in Ohio provide coverage for biomarker testing. The legislation defines "biomarker" and "biomarker testing," and outlines the purposes for which such testing must be covered, including diagnosis, treatment management, and ongoing monitoring of diseases or conditions. Coverage is contingent upon the testing being deemed medically necessary by a qualified healthcare provider and supported by medical or scientific evidence, which can include FDA-approved tests, national coverage determinations, and recognized clinical practice guidelines.

Additionally, the bill requires health plans and Medicaid to ensure that coverage limits disruptions in patient care and allows for appeals regarding coverage determinations. It mandates annual reporting on reimbursement rates and other relevant data related to biomarker testing, aiming to enhance transparency and accountability in the healthcare system. The intent of the General Assembly is to ensure that appropriate biomarker testing is accessible while preventing significant price increases for these tests due to the new coverage requirements.