SB464

West Virginia SB464 requires insurance coverage for biomarker testing when medically indicated.

West Virginia SB464 mandates that health insurers cover biomarker testing when ordered by a treating physician for diagnosis, precision diagnosis, treatment, management, or monitoring of a disease or condition. Coverage is required if the test is medically indicated and demonstrates clinical utility. The bill excludes coverage for screening purposes before diagnosis. Insurers may require prior authorization and must provide a process for exceptions. The Public Employees Insurance Agency and the Bureau of Medical Services must report on the costs of this coverage one year after implementation.