Substitute Senate Bill No. 307, known as Public Act No. 24-50, is a legislative act concerning Medicaid coverage of biomarker testing, which is set to take effect on July 1, 2024. The bill defines "biomarker" as a measurable characteristic that can indicate normal or pathogenic biological processes or responses to therapeutic interventions. "Biomarker testing" refers to the analysis of biospecimens for biomarkers, which can include a range of tests from single substance analysis to whole genome sequencing. The bill also defines "clinical utility" as test results that contribute to treatment or monitoring strategies affecting patient outcomes and clinical decisions, and "consensus statements" as expert-developed statements aimed at optimizing clinical outcomes.

The bill mandates that the Commissioner of Social Services, within federal law limits, provide Medicaid coverage for biomarker testing for diagnosis, treatment, management, or monitoring of a Medicaid enrollee's disease or condition. Coverage is contingent on medical necessity and may be informed by clinical guidelines, including FDA approvals, Medicare determinations, or nationally recognized clinical practice guidelines and consensus statements. The act also clarifies that such guidelines are not the sole basis for determining medical necessity. Additionally, it allows the Department of Social Services to require prior authorization for testing, provides a hearing right for adversely affected Medicaid enrollees, and mandates that coverage is implemented to minimize care disruptions. There are no specific insertions or deletions from current law indicated in the provided text.