This bill establishes new requirements for health plans in Washington State regarding coverage for biomarker testing, effective January 1, 2025. It mandates that health carriers, including those offering plans to public employees and under Medicaid, provide coverage for biomarker testing when it is supported by medical and scientific evidence. The criteria for coverage include tests approved by the FDA, national coverage determinations from Medicare, and nationally recognized clinical practice guidelines. Additionally, the bill emphasizes that coverage should minimize the need for multiple biopsies or biospecimen samples, while allowing health plans to implement prior authorization and utilization management strategies.

The bill defines key terms related to biomarker testing, including what constitutes a biomarker and the types of testing covered. It clarifies that biomarker screening tests and investigatory testing are not required to be covered. The legislation aims to enhance patient care by ensuring that necessary biomarker tests are accessible and supported by established medical guidelines, thereby improving diagnosis, treatment, and ongoing management of diseases.