The Tennessee Senate Commerce and Labor Committee passed a bill this week that would require TennCare and public employee group insurance plans to cover a medical test used to assist with diagnosing diseases.
State senators approved Senate Bill (SB) 0435 by a vote of 8 to 1, requiring these entities to cover biomarker testing when ordered by a healthcare provider. The bill proposal, which was introduced by State Senator Shane Reeves (R-Rutherford County), now goes to the Senate floor for deliberation.
State senators amended SB 0435 to exempt private insurance companies from requiring biomarker testing.
For TennCare patients, it must be medically necessary for coverage.
To be covered by insurance, biomarker testing must be proven safe and effective and be backed by the Food and Drug Administration, SB 0435 says.
The bill proposal states that insurance need not cover testing for people without symptoms; rather, testing must be linked to a specific medical need or condition.
Insurance companies can still require prior authorization, SB 0435 says, adding that they don’t have to respond to these requests within a set time frame. Under the original bill proposal, insurance companies would have had to respond within 24 hours in an urgent situation and within 72 hours in a non-urgent situation.
SB 0435 would require Tennessee to track the use of biomarker testing and the associated cost savings for TennCare. The report would be due by February 1st, 2029.
If the bill proposal becomes law, it will take effect on January 1, 2027. Tennessee would be the 24th state to expand coverage of biomarker testing.
Maddie Michael, the Tennessee government relations director for the American Cancer Society Cancer Action Network, a nonprofit advocacy group, said biomarker testing “will enable more patients to access the most effective treatments for their disease and can help achieve the triple aim of health care: better health outcomes, improved quality of life, and reduced costs.”
Stephen Huff, a triple-positive breast cancer survivor who lives in College Grove, shared his story with state legislators.
Huff said biomarker testing is “the single most important thing” that has kept him “alive this long.”
“We always dreamed of having a family, and with my diagnosis, we weren’t sure if it would ever be possible. Biomarker testing and precision medicine helped make that possible and has given me more time to be here with my wife and kids,” he added.
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Zachery Schmidt is the digital editor of The Star News Network. Email tips to Zachery at zschmidt1717@gmail.com.
