HASBSB118 TYLERT 4279
SENATE SUMMARY OF HOUSE AMENDMENTS
SB 118 2022 Regular Session Talbot
KEYWORD AND SUMMARY AS RETURNED TO THE SENATE
HEALTH/ACC INSURANCE. Requires medical necessity for genetic testing of
certain cancer mutations is based on nationally recognized clinical practice
guidelines. (1/1/23)
SUMMARY OF HOUSE AMENDMENTS TO THE SENATE BILL
1. Adds 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. Modifies the definition of "biomarker testing" to include whole exome and
whole transcriptome sequencing.
3. Makes technical changes including modifications to the definitions of
"consensus statements" and "nationally recognized clinical practice
guidelines".
4. Excludes plans offered through the office of group benefits from definition
of a "health coverage plan".
DIGEST OF THE SENATE BILL AS RETURNED TO THE SENATE
DIGEST
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 diagnostic 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.
Present law defines "health coverage plan" but proposed law provides that "health coverage
plan" does not include any plan offered through the office of group benefits.
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Proposed law defines "consensus statements" and "nationally recognized clinical practice
guidelines".
Effective on January 1, 2023.
(Amends R.S. 22:1028.3(B)(2), (C), and (D)(intro. para.) and (2); Adds R.S.
22:1028.3(D)(3) and (4))
______________________
Thomas L. Tyler
Senate Counsel
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