SB 24-124 CO Became Law
Health-Care Coverage for Biomarker Testing
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Summary
The act requires all large group health benefit plans to provide coverage for biomarker testing to guide treatment decisions if the testing is supported by medical and scientific evidence. The act defines "biomarker testing" as an analysis of a patient's tissue, blood, or other biospecimen for the presence of an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention. The required testing under the act does not include biomarker testing for screening purposes or direct-to-consumer genetic tests. The act requires the commissioner of insurance to implement biomarker testing coverage for all large employer health benefit plans issued or renewed on or after January 1, 2025. To the extent biomarker testing is not in addition to the benefits provided pursuant to the benchmark plan, all individual and small group health benefit plans must provide coverage for biomarker testing. Within 120 days after the act takes effect, the division of insurance (division) shall submit to the federal department of health and human services (HHS) its determination of whether biomarker testing is in addition to essential health benefits and would require state defrayal of costs pursuant to federal law. The division shall implement the requirement for coverage for biomarker testing for individual and small group health benefit plans within 12 months after the earlier of the division receiving confirmation from HHS that biomarker coverage does not require defrayal or more than 365 days passing since the division submitted its determination that defrayal was not necessary. Biomarker testing is subject to the health benefit plan's annual deductibles, copayment, or coinsurance but is not subject to any annual or lifetime maximum benefit limit. APPROVED by Governor June 3, 2024 EFFECTIVE June 3, 2024(Note: This summary applies to this bill as enacted.)
Sponsors (4)
- Dafna Michaelson Jenet · primary
- Janice Rich Republican · primary
- Anthony Hartsook Republican · primary
- Monica Duran Democratic · primary
Action history (14)
- Jun 3, 2024 Governor Signed · executive
- May 17, 2024 Sent to the Governor · executive
- May 17, 2024 Signed by the Speaker of the House · lower
- May 17, 2024 Signed by the President of the Senate · upper
- May 6, 2024 Senate Considered House Amendments - Result was to Concur - Repass · upper
- May 5, 2024 House Third Reading Passed - No Amendments · lower
- May 4, 2024 House Second Reading Special Order - Passed with Amendments - Committee · lower
- May 2, 2024 House Committee on Health & Human Services Refer Amended to House Committee of the Whole · lower
- Apr 26, 2024 Introduced In House - Assigned to Health & Human Services · lower
- Apr 26, 2024 Senate Third Reading Passed - No Amendments · upper
- Apr 25, 2024 Senate Second Reading Passed with Amendments - Committee, Floor · upper
- Apr 23, 2024 Senate Committee on Appropriations Refer Unamended to Senate Committee of the Whole · upper
- Apr 11, 2024 Senate Committee on Health & Human Services Refer Amended to Appropriations · upper
- Feb 6, 2024 Introduced In Senate - Assigned to Health & Human Services · upper
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