RDCSB118 3264 3668
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
SB 118 Engrossed 2022 Regular Session Talbot
Present law requires a health coverage plan in this state to include coverage for genetic or
molecular testing for cancer including but not limited to tumor mutation testing, next
generation sequencing, hereditary germline mutation testing, pharmacogenomic testing,
whole exome and genome sequencing, and biomarker testing. Proposed law retains present
law.
Present law provides that coverage may be subject to annual deductibles, coinsurance, and
copayments established under a health coverage plan. Proposed law retains present law.
Present law provides that coverage may be subject to applicable evidence-based medical
necessity criteria of a health coverage plan. Proposed law deletes present law.
Proposed law requires coverage for biomarker testing for the purposes of diagnosis,
treatment, appropriate management, or ongoing monitoring of an individual's disease or
condition when the test is supported in certain respects by any of the following: the U.S.
Food and Drug Administration (FDA), Centers for Medicare and Medicaid Services National
Coverage Determinations, Medicare Administrative Contractor Local Coverage
Determinations, National Comprehensive Cancer Network, or American Society of Clinical
Oncology.
Present law defines "biomarker testing". Proposed law expands the definition to include
whole exome and whole transcriptome sequencing. Otherwise retains the present law
definition.
Proposed law defines "consensus statements" and "nationally recognized clinical practice
guidelines".
Effective on July 1, 2022.
(Amends R.S. 22:1028.3(B)(2) and (D)(intro. para.) and (2); Adds R.S. 22:1028.3(D)(3) and
(4))
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Insurance to the original
bill
1. Makes technical changes.
2. Adds provision requiring an insurer cover biomarker testing for the purposes
of diagnosis, treatment, appropriate management, or ongoing monitoring of
an individual's disease or condition when the test is supported by, but not
limited to labeled indications for tests approved or cleared by the United
States Food and Drug Administration (FDA), or indicated tests for drugs
approved by the FDA, or the Centers for Medicare and Medicaid Services
National Coverage Determinations, or Medicare Administrative Contractor
Local Coverage Determinations, or a nationally recognized clinical practice
guidelines and consensus statements.
3. Adds definitions for "consensus statements" and a "nationally recognized
clinical practice guidelines".
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Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the
engrossed bill:
1. Add that biomarker tests may be supported for coverage by nationally
recognized consensus statements and clinical practice guidelines
provided by the National Comprehensive Cancer Network or the
American Society of Clinical Oncology.
2. Modify the definition of "biomarker testing" to include whole exome and
whole transcriptome sequencing.
3. Make technical changes including modifications to the definitions of
"consensus statements" and "nationally recognized clinical practice
guidelines".
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