LCO No. 3685 1 of 2
General Assembly Raised Bill No. 820
January Session, 2019
LCO No. 3685
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT WAIVING PRIOR MEDICAID AUTHORIZATION
REQUIREMENTS FOR CER TAIN PHARMACOGENOMIC S TESTS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2019) (a) For purposes of this 1
section, (1) "pharmacogenomics" means the study of how an 2
individual's genetic makeup, or genotype, affects the body's response 3
to prescription drugs, and (2) "medically necessary" means a 4
determination by a treating primary care practitioner made in 5
accordance with section 17b-259b of the general statutes. 6
(b) The Commissioner of Social Services shall provide Medicaid 7
coverage, to the extent permissible under federal law , for 8
pharmacogenomics tests determined to be medically necessary. The 9
commissioner shall not require prior authorization for medically 10
necessary pharmacogenomics tests for persons being treated for (1) 11
behavioral disorders, (2) psychiatric disorders, (3) cardiovascular 12
disorders, and (4) chronic pain. 13
(c) In contracting with a provider for the provision of 14 Raised Bill No. 820
LCO No. 3685 2 of 2
pharmacogenomics tests, the commissioner may give preference to any 15
Medicaid-enrolled laboratory provider that offers a discounted price 16
for such tests. If necessary, the commissioner shall amend the 17
Medicaid state plan to provide coverage for pharmacogenomics tests. 18
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2019 New section
Statement of Purpose:
To waive prior Medicaid authorization requirements for certain
pharmacogenomics tests.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
not underlined.]