Committee advances bill to require coverage for FDA‑approved biomarker testing when medically necessary
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Summary
The House Government Operations Committee advanced HB 484 after physician testimony that biomarker testing improves diagnosis and treatment selection. Lawmakers pressed on prior‑authorization timelines and whether genetic or biomarker results could affect insurance coverage; the committee voted 15–0 to move the bill to Finance and Ways and Means.
Representative Martin’s HB 484, which would require coverage of FDA‑approved biomarker tests when ordered by a provider and meeting medical necessity, advanced from the House Government Operations Committee following expert testimony and member questions.
Neurologist David Charles of Vanderbilt University, speaking for the nonprofit Alliance for Patient Access, told the committee biomarker testing lets clinicians “select the right therapy,” improving outcomes in cancer, rheumatology and neurology. He gave a personal example of a patient‑facing cost: “My doctor tells me…it's $3,000 out of pocket. Insurance doesn't cover it,” Charles said, noting most patients cannot afford such tests. He said guardrails in the bill require tests to be FDA‑approved or consistent with Medicare policy and evidence‑based practice guidelines.
Members asked about economic evidence and patient protections. Representative Hartwell asked whether Charles could quantify the economic trade‑offs of early detection; Charles said he had no dollar study to present but described clinical benefits and argued early, accurate diagnosis can reduce ineffective spending. Representative Clemens pressed to confirm that the amended bill preserves statutory timelines for prior authorization (24 hours for urgent, 72 hours for non‑urgent); the sponsor confirmed the amendment references state law and maintains those timelines.
Representative Fritsch raised privacy and life‑insurance concerns after noting family experience with Alzheimer’s. He asked whether results could be shared in ways that would harm consumers. Charles said he was not an expert on life‑insurance regulation but pointed to federal protections against discrimination based on health status, saying he expected data protections to limit misuse.
After brief additional sponsor comments and a motion, the clerk reported a 15–0 vote to advance HB 484 to the Finance and Ways and Means Committee.
Next steps: the bill will be considered in Finance and Ways and Means, where sponsors indicated they will address a date component and other technical amendments before further action.