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Insurance committee advances bill to require coverage of biomarker tests for treatment and management
Summary
The Tennessee House Insurance Committee voted 16-1 on March 19 to advance House Bill 484, which would require insurers to cover biomarker testing when ordered by a provider for diagnosis, treatment and management of a condition; members debated a distinction between screening and treatment.
The Tennessee House Insurance Committee on March 19 voted 16-1 to advance House Bill 484, as amended, which would require insurers to cover biomarker testing when ordered by a provider for diagnosis, treatment and management of a condition. Chairman Martin, sponsor of the bill, explained the proposal and its guardrails.
"The intent of this bill is to get patients across Tennessee the right treatment at the right time, timely diagnosis, and appropriate management for conditions," Chairman Martin told the committee, summarizing the amended language that excludes screening tests and requires that tests be supported by medical and scientific evidence.
Committee members pressed on where the bill draws the line between screening and treatment. Representative Kumar said the bill is aimed at tests used in treatment and management — for example, tests used to guide cancer therapy or to follow biomarkers after surgery — and not broad population screening. "We need to make a distinction between these biomarkers if they are used for treatment and management of a disease versus screening," Kumar said during debate.
Representative Freeman described a personal experience supporting the bill. "I truly don't believe that my wife would be here today if not for these biomarker screenings," Freeman said, arguing faster, targeted treatment can save money and lives.
Opponents raised concerns about mandating coverage for tests that insurers typically deny when used for broad screening, with one member noting the free-market argument for patients paying out of pocket for nonmedical screening. Supporters and the sponsor repeatedly emphasized that the bill excludes screening and is limited to medically justified tests.
The committee adopted amendment 5211 before the vote. On a recorded voice vote, the committee approved House Bill 484, 16–1, and referred it to the Government Operations committee.
With the amendment, the bill directs insurers to cover biomarker tests that are ordered by a provider for diagnosis, treatment or management when the tests are supported by medical and scientific evidence; it explicitly excludes general screening tests. The sponsor said the bill follows models enacted in other states and is intended to speed access to appropriate targeted therapies.
