HEALTH INSURERS This bill requires a health insurer that issues, amends, delivers, or renews a contract or agreement for a health benefit plan to take effect on or after January 1, 2026, to include coverage for biomarker testing for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the test is supported by medical and scientific evidence, including, but not limited to, (i) labeled indications for a federal food and drug administration (FDA)-approved or FDA-cleared test; (ii) indicated tests for an FDA-approved drug; (iii) warnings and precautions on FDA-approved drug labels; (iv) centers for medicare and medicaid services national coverage determinations or medicare administrative contractor local coverage determinations; or (v) nationally recognized clinical practice guidelines and consensus statements. This bill requires a health insurer to ensure that biomarker testing coverage under this bill is provided in a manner that limits disruptions in care, including the need for multiple biopsies or biospecimen samples. If utilization review, including, but not limited to, prior authorization is required, then the health insurer, nonprofit health service plan, health maintenance organization, utilization review entity, or a third party acting on behalf of an organization or entity must approve or deny a prior authorization request and notify the enrollee, the enrollee's healthcare provider, and each entity requesting authorization of the service within 72 hours of a non-urgent request or within 24 hours of an urgent request. This bill requires a patient and prescribing practitioner to have access to a clear, readily accessible, and convenient process to request an exception to a coverage policy or an adverse utilization review determination of a health insurer, nonprofit health service plan, or health maintenance organization. The process must be made readily accessible on the public website of the health insurer, nonprofit health service plan, or health maintenance organization. This bill authorizes the commissioner of commerce and insurance to promulgate rules to effectuate this bill. TENNCARE This bill requires a TennCare health benefit plan that is issued, amended, or renewed to take effect on or after January 1, 2026, to provide coverage for biomarker testing. Biomarker testing must be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the test is supported by medical and scientific evidence, including, but not limited to, (i) labeled indications for a federal food and drug administration (FDA)-approved or FDA-cleared test; (ii) indicated tests for an FDA-approved drug; (iii) warnings and precautions on FDA-approved drug labels; (iv) centers for medicare and medicaid services national coverage determinations or medicare administrative contractor local coverage determinations; or (v) nationally recognized clinical practice guidelines and consensus statements. This bill requires a health insurer that issues a TennCare health benefit plan to provide biomarker testing within the same scope, and at the same duration and frequency, that other TennCare benefits are provided to enrollees. If utilization review, including, but not limited to, prior authorization is required, then the health insurer, nonprofit health service plan, health maintenance organization, utilization review entity, or a third party acting on behalf of an organization or entity must approve or deny a prior authorization request and notify the enrollee, the enrollee's healthcare provider, and each entity requesting authorization of the service within 72 hours of a non-urgent request or within 24 hours of an urgent request. This bill requires an enrollee and participating provider to have access to a clear, readily accessible, and convenient process to request an exception to a coverage policy of, or an adverse utilization review by, a health insurer that issues a TennCare health benefit plan. The process must be made readily accessible on the public website of TennCare and each health insurer that issues TennCare health benefit plans. This bill authorizes the director of TennCare is authorized to seek any federal waiver the director deems necessary to effectuate this bill.