Bill H.136 proposes to mandate health insurance and Medicaid coverage for biomarker testing in Vermont. The bill introduces new sections to the Vermont Statutes, specifically 8 V.S.A. 4088n and 33 V.S.A. 1901n, which define biomarker testing and outline the conditions under which coverage must be provided. Biomarker testing is defined as the analysis of a patient's tissue, blood, or other biospecimens to identify biomarkers, which are indicators of biological processes or responses to treatments. Coverage is required when the testing is supported by medical evidence, including FDA approvals, indications for FDA-approved drugs, and nationally recognized clinical practice guidelines.

Additionally, the bill stipulates that the coverage must be provided in a way that minimizes disruptions in patient care, such as avoiding the need for multiple biopsies. The Agency of Human Services is tasked with ensuring Medicaid coverage aligns with these requirements and may need to amend Vermont's Medicaid state plan to do so. The effective date for health insurance coverage is set for January 1, 2026, while Medicaid coverage will take effect either on that date or upon approval of the necessary state plan amendment.