The New Hampshire Legislature has introduced Senate Bill 120, aimed at amending RSA 420-J to require health carriers to cover biomarker testing. This bill, introduced on January 22, 2025, seeks to enhance patient access to critical diagnostic tools that can aid in the treatment and management of various health conditions.

The key provisions of SB 120 mandate that health insurers provide coverage for biomarker testing, which is essential for personalized medicine. While some biomarker tests may already be included under the state’s Benchmark Plan when deemed medically necessary, this legislation would establish additional requirements for coverage, potentially expanding the scope of benefits available to patients.

A notable aspect of the bill is the introduction of new prior authorization timeframes. Under Section 420-J:21, IV, insurers would be required to respond to non-urgent requests within 72 hours and urgent requests within 24 hours. These timeframes conflict with existing regulations, which allow for 7 calendar days for non-urgent cases and 72 hours for urgent ones, raising concerns about the administrative burden on insurers and the potential for delays in patient care.

The financial implications of SB 120 are complex and largely indeterminate. The Insurance Department has indicated that while increased utilization of biomarker testing may initially raise costs for insurers, the potential for earlier detection and more targeted treatments could lead to better health outcomes and reduced long-term expenses. However, if the mandated benefits exceed those covered under the Benchmark Plan, the state may incur additional costs, particularly for Qualified Health Plan enrollees, starting in fiscal year 2026.

The bill has garnered attention from various stakeholders, including the Insurance Department and the Department of Health and Human Services, as they assess its potential impact on healthcare costs and patient access. As discussions continue, the outcome of SB 120 could significantly influence the landscape of health insurance coverage in New Hampshire, particularly regarding the integration of advanced diagnostic testing into standard care practices.

In conclusion, Senate Bill 120 represents a significant step toward enhancing healthcare access through biomarker testing, though its financial ramifications and administrative challenges will require careful consideration as it moves through the legislative process.