Committee advances bill to require insurer coverage for provider-ordered biomarker testing

The House Government Operations Committee voted 15–0 to advance House Bill 484, sponsored by Representative Martin, which would require health insurers to cover FDA‑approved biomarker testing when ordered by a provider who determines the test meets medical necessity.

Sponsor Representative Martin said the bill is meant to remove access barriers that prevent timely, targeted care. Representative Martin said the bill excludes screening tests and that certain timing and prior‑authorization provisions will be refined at the finance committee stage. "Every one of us has been impacted directly by cancer," he told the committee, framing biomarker coverage as an access issue.

Dr. David Charles, a neurologist at Vanderbilt testifying for the Alliance for Patient Access, told members biomarker testing improves diagnostic accuracy and helps clinicians choose therapies with the best likelihood of benefit. He gave a patient example in which a needed genetic test carried a roughly $3,000 out‑of‑pocket cost and said those costs often keep patients from getting appropriate testing. "Patients need access to biomarkers," he said.

Members pressed on economics and privacy. Representative Hardaway asked for side‑by‑side economic data on early detection versus late‑stage treatment; Dr. Charles said he had no dollar report but stressed the clinical axiom that early diagnosis improves outcomes. Representative Fritz, citing a family history of Alzheimer’s, asked whether test results could be shared with other carriers or affect life or auto insurance; Dr. Charles pointed to federal protections against health‑status discrimination by health insurers but said he was not an expert on non‑health insurers’ practices.

The committee clerk opened the board and reported 15 ayes and 0 nays. The bill was advanced to finance and ways and means with the sponsor indicating a limited change on a date component would be made in finance.