Maine 2025-2026 Regular Session

Maine House Bill LD107

Introduced
1/8/25  
Refer
1/8/25  
Refer
1/8/25  
Engrossed
5/22/25  

Caption

An Act to Require Health Insurance Coverage for Biomarker Testing

Impact

The impact of LD107 on state laws could be significant, as it alters existing insurance coverage requirements to include biomarker testing. This means that health insurers would now be legally obligated to cover tests that can help tailor treatments to individual patient needs, promoting a more personalized approach to healthcare. The legislation aims to reduce financial barriers for patients requiring these tests, potentially improving early detection and treatment efficacy for a variety of health conditions, especially in oncology and rare genetic disorders.

Summary

LD107 is an Act to require health insurance coverage for biomarker testing, aiming to improve patient outcomes through personalized medicine. The legislation mandates that individual and group health insurance policies, including MaineCare, provide coverage for biomarker testing that is medically necessary for the diagnosis, treatment, management, or ongoing monitoring of diseases. The definition of 'biomarker' encompasses various indicators derived from biological samples which may inform treatment decisions. The bill highlights the importance of ensuring that such tests are supported by substantial medical evidence and specified standards, improving access to advanced medical technologies for patients in Maine.

Sentiment

The sentiment surrounding the bill appears to be largely supportive from healthcare professionals and advocates for patient rights. They argue that increased access to biomarker testing is crucial for advancing the quality of patient care and outcomes. However, there may also be concerns from insurance companies about the potential increase in costs and how this could impact overall healthcare spending. Continued discussions are likely to address these issues and highlight the necessity of balancing cost with enhanced patient care.

Contention

Notable points of contention include the implementation of coverage requirements and the specifics of which biomarker tests will be included under the legislation. Stakeholders may debate the definition of 'medically necessary' testing and how to ensure that coverage remains sustainable for insurers. There may also be discussions on the need for appropriate oversight and guidelines to ensure that tests are not only available but also effective and validated, preventing unnecessary healthcare expenditures and ensuring patient safety.

Companion Bills

No companion bills found.

Similar Bills

AZ HB2144

Health insurance coverage; biomarker testing

WV HB4753

Relating to providing health insurance coverage concerning biomarker testing

CA SB496

Biomarker testing.

CA SB912

Biomarker testing.

LA SB118

Requires medical necessity for genetic testing of certain cancer mutations is based on nationally recognized clinical practice guidelines. (7/1/22) (EN NO IMPACT See Note)

NM HB73

Biomarker Testing Insurance Requirements

NJ S3098

Requires health insurers to provide coverage for biomarker precision medical testing.

NJ A4163

Requires health insurers to provide coverage for biomarker precision medical testing.