Texas HB5178 mandates health benefit plans to cover biomarker testing for diagnosis, treatment, and management of diseases.

HB5178 amends the Texas Insurance Code to require health benefit plans to cover biomarker testing for diagnosis, treatment, management, or monitoring of an enrollee's disease or condition. This coverage is required when the test is supported by specific medical and scientific evidence, including FDA approvals, Medicare determinations, clinical guidelines, or consensus statements. The law applies to health benefit plans delivered, issued for delivery, or renewed on or after January 1, 2026. The act takes effect September 1, 2025.

Texas HB5178 mandates health benefit plans to cover biomarker testing for diagnosis, treatment, and management of diseases.

HB5178 amends the Texas Insurance Code to require health benefit plans to cover biomarker testing for diagnosis, treatment, management, or monitoring of an enrollee's disease or condition. This coverage is required when the test is supported by specific medical and scientific evidence, including FDA approvals, Medicare determinations, clinical guidelines, or consensus statements. The law applies to health benefit plans delivered, issued for delivery, or renewed on or after January 1, 2026. The act takes effect September 1, 2025.