Lawmakers weigh mandatory coverage for biomarker testing; agencies urge caution

The House Health Care & Wellness Committee held a public hearing Jan. 21 on House Bill 1062, which would require coverage of biomarker testing by state‑regulated health plans, public employee plans and Medicaid when the tests meet medical and scientific criteria.

Committee staff explained the bill’s scope and a recent mandated benefit review (MBR). "A biomarker is a measurable substance that may indicate a disease, infection, or environmental exposure," said Jim Morishima, staff to the committee, and he noted the Department of Health’s 2024 MBR concluded it could not recommend adopting a broad mandated benefit because of definitional and evidentiary challenges.

Patient advocates, clinicians and industry groups urged the committee to require coverage for tests that guide care. Katie Cole…