HB1589--MEDICALTESTING
SPONSOR: Veit
MEDICALTESTINGUNDERMOHEALTHNET(Sections191.300,191.312,and
208.152)
Underthisbill,theDepartmentofHealthandSeniorServicesmust
offerapubliccommentperiodeachyeartocollectcommentsand
informationpertainingtobestpracticesingenetically-based
newbornscreeningforpediatricrarediseases. TheDepartmentwill
alsoannuallyseekoutinformationandresearchupdatesfrom
prenatalandearlychildhoodgeneticscreeningresearch
organizations. TheDepartmentwillcompilethisinformationinan
annualreporttotheGovernorandGeneralAssemblyandmustinclude
anyrecommendations foranyupdatesfornewbornscreening.
Additionally,theDepartmentofSocialServiceswillinclude
coverageofgenetictestingforpediatricrarediseasesasa
coveredMOHealthNetservice. Rapidwholegenomesequencing
testingwillbecoveredincertaininpatientsettings,while
biomarkertestingwillbecoveredincertainoutpatientsettings.
TheDepartmentmustseekanynecessaryStateplanamendmentsor
waiversfromtheCentersforMedicareandMedicaidServicesto
implementthisprovision.
MEDICALTESTINGUNDERHEALTHBENEFITPLANS(Section376.1270)
Thisbillrequireshealthbenefitplanstoprovidecoveragefor
biomarkertesting,asdefinedinthebill,aswellasforrapid
wholegenomesequencing(rWGS),asdefinedinthebill.Thebill
specifieswhenthetestingwillbecovered,includesexamplesof
medicalnecessity,enactsprovisionsrelatingtoprior
authorizationandutilizationreviewfortheservices,prohibits
coveragedenialsbasedonthetestsbeingexperimentalor
investigational, specifiesthatgeneticcounselingbeforeandafter
thetestsiscovered,requireshealthcarrierstomaintainontheir
websitesup-to-datepoliciesoncoveredgenomicandbiomarker
tests,andrequirestestingunderthebilltobeperformedbya
laboratorycertifiedinaccordancewithFederallaw.
ThisbillissimilartoSB828(2025).