An act relating to health insurance coverage for biomarker testing
Impact
If enacted, H0136 will reform the existing state laws related to health insurance coverage in Vermont. It requires that all health insurance plans and Medicaid programs provide necessary coverage for biomarker testing, which is vital for selecting appropriate therapies based on patients' biological characteristics. The bill emphasizes reducing disruptions in patient care, ensuring that patients have consistent access to these essential medical services without the need for unnecessary repeat biopsies or biospecimen sampling.
Summary
House Bill H0136 seeks to mandate health insurance and Medicaid coverage for biomarker testing, which plays a crucial role in diagnosing and treating various diseases. The legislation defines biomarkers broadly, encompassing characteristics that can be measured to signify normal or pathogenic biological processes, and includes a wide array of testing methodologies such as single-analyte tests and sequencing technologies. By ensuring coverage for these tests, the bill aims to improve patient care through better-targeted treatments based on individual biomarker profiling.
Contention
While proponents of H0136 argue that it will enhance patient outcomes through more personalized medical care, there may be concerns regarding cost implications for insurance providers. Some legislators and healthcare experts believe that the, potentially substantial, increase in testing and treatment costs could impact overall healthcare spending in Vermont. Additionally, there could be debates over the criteria for which biomarker tests receive coverage, particularly around the medical and scientific evidence necessary to justify such tests being reimbursed under health insurance plans.
To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act; And To Update Language And Definitions To Reflect Changes Within The Healthcare System;.
Criminal procedure: sentencing guidelines; sentencing guideline for wage and fringe benefit payment violations; enact. Amends sec. 14a, ch. XVII of 1927 PA 175 (MCL 777.14a). TIE BAR WITH: HB 4318'25