On January 22, 2025, the New Hampshire Legislature introduced Senate Bill 120, aimed at expanding insurance coverage for biomarker testing under the state Medicaid plan. This legislative proposal seeks to ensure that risk-bearing entities contracted to deliver Medicaid services provide biomarker testing at the same scope, duration, and frequency as currently available to enrollees.

Key provisions of the bill include mandates for the state Medicaid plan to limit disruptions in care, thereby reducing the need for multiple biopsies or biospecimen samples. Additionally, the bill stipulates that any prior authorization requests for biomarker testing must be processed within 72 hours for non-urgent cases and 24 hours for urgent requests. It also establishes a clear process for enrollees and providers to request exceptions to coverage policies, which must be easily accessible online.

The bill's introduction has sparked discussions regarding its potential economic and social implications. While it does not allocate specific funding, the fiscal note indicates that the financial impact on state revenue and expenditures remains indeterminable for the upcoming fiscal years. The Office of Legislative Budget Assistant is currently awaiting further information from the Department of Health and Human Services to provide a complete fiscal analysis.

As the bill progresses, it may face debates surrounding the balance between expanding healthcare access and managing state budget constraints. Experts suggest that if passed, SB 120 could significantly enhance patient care by facilitating timely access to critical diagnostic tools, ultimately improving health outcomes for Medicaid beneficiaries.

Senate Bill 120 is set to take effect on July 1, 2025, pending further legislative review and approval. The outcome of this bill could reshape the landscape of healthcare services in New Hampshire, particularly for those reliant on Medicaid for their medical needs.