HB242INTRODUCED
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HB242
LUZ7AWY-1
By Representative Rigsby
RFD: Ways and Means General Fund
First Read: 11-Feb-25
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5 LUZ7AWY-1 02/05/2025 JC (L)lg 2025-284
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First Read: 11-Feb-25
SYNOPSIS:
Under existing law, the Medicaid program does
not cover rapid whole genome sequencing.
This bill would require Medicaid to pay for
rapid whole genome sequencing for hospitalized infants,
children, and younger adults who suffer from acute or
complex illnesses that have causes that elude the more
conventional means of medical detection, in order to
determine if the origin is genetic.
A BILL
TO BE ENTITLED
AN ACT
Relating to Medicaid, to require coverage of rapid
whole genome sequencing for certain individuals in the
Medicaid program.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. (a) For the purposes of this section, "rapid
whole genome sequencing" is defined as an investigation of the
entire human genome, including coding and non-coding regions
and mitochondrial deoxyribonucleic acid, which yields a
preliminary positive result of a disease-causing genetic
change within five days, and a final result of the same within
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change within five days, and a final result of the same within
14 days. The term includes patient-only whole genome
sequencing and duo and trio whole genome sequencing of the
patient and his or her biological parents.
(b) Subject to prior approval or a waiver from the
Centers for Medicare and Medicaid Services, the Alabama
Medicaid Agency shall cover rapid whole genome sequencing for
an individual covered by Medicaid who meets all of the
following criteria:
(1) Is 21 years of age or younger.
(2) Has a complex or acute illness of unknown etiology
that is not confirmed to be caused by environmental exposure,
toxic ingestion, infection that responds to therapy, or
trauma.
(3) Is a hospital inpatient in an intensive care unit,
including a neonatal intensive care unit, or a high acuity
pediatric unit.
Section 2. This act shall become effective on October
1, 2025.
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