The bill proposes the enactment of section 5167.124 of the Revised Code, which mandates that Medicaid managed care organizations cover pharmacogenomic testing deemed medically necessary. Pharmacogenomic testing is defined as laboratory genetic testing that assesses how an individual's genetic profile may affect the efficacy, safety, or toxicity of prescribed medications, particularly for those diagnosed with mental or behavioral health conditions such as depression or anxiety. The bill outlines specific criteria for when pharmacogenomic testing is considered medically necessary, including the requirement that it be ordered by a treating prescriber and that it is covered by Medicare under a local coverage determination.

Additionally, the bill allows Medicaid managed care organizations to impose prior authorization requirements for pharmacogenomic testing, ensuring that these requirements do not create undue administrative burdens or delays in care. The Department of Medicaid is tasked with monitoring these requirements and can impose penalties on organizations that fail to comply, including fines and the potential suspension or termination of contracts. The bill also establishes a process for reporting noncompliance, supplementing existing grievance procedures.