Senate Bill 435 amends Tennessee law to mandate coverage for biomarker testing by health insurers and TennCare health benefit plans, effective January 1, 2026. The bill defines key terms such as "biomarker," "biomarker testing," "health benefit plan," and "health insurer," and outlines the conditions under which biomarker testing must be covered. Specifically, coverage is required for tests that are supported by medical and scientific evidence, including FDA-approved tests, indications for FDA-approved drugs, and nationally recognized clinical practice guidelines. The bill also stipulates that health insurers must ensure that coverage for biomarker testing minimizes disruptions in patient care and provides a clear process for prior authorization requests.

Additionally, the bill establishes that if prior authorization is required, health insurers must respond to requests within specified timeframes, ensuring timely access to necessary testing. It also mandates that both patients and healthcare providers have access to a straightforward process for requesting exceptions to coverage policies. The director of TennCare is authorized to seek federal waivers as needed to implement these provisions. The commissioner of commerce and insurance is tasked with promulgating rules to effectuate the bill's requirements.