Supporters say biomarker testing can tailor cancer and Alzheimer’s care; insurers and Medicaid urge limits and clinical utility review

Senate Bill 120, introduced on behalf of Sen. Dan Innis, would require commercial health plans and Medicaid to cover biomarker testing when the test is supported by medical and scientific evidence. Proponents said biomarker testing guides precision medicine — especially in oncology and in diagnosis of Alzheimer's disease — and can help doctors avoid ineffective treatments and improve patient outcomes.

Grant Bossi, deputy chief of staff for the Senate, described the bill’s intent: “Biomarker testing is a tool we can use to improve treatment and outcomes, avoid unnecessary medical interventions and lower costs across New Hampshire's healthcare system.” Cancer advocates, the Alzheimer's Association and patients gave examples where testing confirmed a diagnosis or pointed clinicians to targeted therapies that changed care and, in some cases, allowed patients to avoid chemotherapy.

The Alzheimer’s Association and several patients told the committee earlier detection through biomarker tests enables access to treatment options most effective in early disease stages and creates time for care planning. Jenny Horgan of the Alzheimer’s Association said the tests are “one of the most promising paths to improve dementia detection, diagnosis, and treatments,” while patients recounted multi‑year diagnostic delays that testing could have shortened.

Insurers raised concerns that the bill’s definitions are broad and could require coverage of many tests that lack demonstrated clinical utility. Peter Bragdon and representatives from Anthem urged clarity: cover testing when it is medically necessary and supported by well‑established guidelines; otherwise coverage requirements could create large, indeterminable costs. The New Hampshire Division of Medicaid said it already covers medically necessary biomarker testing and estimated the bill could raise Medicaid costs by roughly $1,000,000 to $2,500,000 depending on scope and uptake.

Committee members pressed witnesses on intent, definitions of “medical and scientific evidence,” turnaround times for prior authorization, and whether the bill would inadvertently require universal testing. Some advocates said the bill ties coverage to peer‑reviewed evidence and common clinical guidelines; insurers and the state asked for amendments to maintain a clinical‑utility review to ensure testing informs treatment decisions.

Ending: The committee took testimony and asked for specificity and proposed amendments; no vote was taken. Sponsors and advocates were asked to work with insurers and Medicaid to refine language that preserves access to evidence‑based testing while protecting program budgets and administrative processes.