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Pennsylvania Becomes 20th US State to Enact Comprehensive Biomarker Legislation

NEW YORK – Pennsylvania Gov. Josh Shapiro this week signed into law a bill requiring that state-regulated health insurance policies, including Medicaid, cover comprehensive biomarker testing.

The law aims to increase access to precision medicine for patients with cancer and other diseases. "By expanding access to biomarker testing and precision medicine, we can detect diseases and tailor treatments to the individual needs of each patient," Pennsylvania Sen. Devlin Robinson, one of the sponsors of the bill, said in a statement.

Robinson sponsored a companion bill in the Senate to House Bill 1754, which stipulates that insurers must cover biomarker testing for diagnosis, treatment, monitoring, and appropriate management of a covered person's illness. The law notes, however, that covered biomarker testing will be subject to a health insurer's coverage criteria and policies around medical necessity. The law doesn't require coverage of screening tests that determine a person's risk for a disease.

Pennsylvania is the 20th state to enact comprehensive biomarker testing legislation, according to the American Cancer Society Cancer Action Network (ACS-CAN), the organization that penned model legislative language for these bills. Other states that have passed such legislation into law recently include Indiana and Texas. Biomarker legislation has been introduced in a handful of other states such as Massachusetts.

"Despite the proven benefits, insurance coverage has failed to keep pace with innovations and advancements in biomarker testing and treatment, resulting in some patients being forced to decide whether to pay out-of-pocket or go without the testing that may connect them with lifesaving treatment," ACS-CAN said in a statement. "House Bill 1754 will help address these gaps in access to biomarker testing."