Acting Governor Way signs legislation requiring insurance coverage for biomarker testing
Biomarker testing analyzes an individual’s unique biological indicators to provide insights into their health status or risk of certain diseases like cancer. Biomarkers can inform certain treatment plans, making this form of testing a critical step to applying precision medicine and targeted therapies that can improve health outcomes and provide for better quality of life.
“We are continuing to advance our mission to make high-quality health care more affordable and accessible in New Jersey. By eliminating barriers to accessing biomarker testing, we are making it easier for families in our state to access personalized treatment plans,” said Way. “For someone battling life-altering and potentially fatal diseases like cancer, having this testing covered by insurance could make a world of difference in their treatment plan.”
Under the bill, state-regulated health insurance providers, Medicaid, and the SHBP and SEHBP are required to provide coverage for biomarker testing for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an individual’s disease or condition when the test is supported by medical and scientific evidence.
“Biomarker precision medical testing helps guide health professionals with more detailed information to diagnose or provide targeted treatment options for diseases, which can lead to improved health outcomes,” said New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman. “With this law, New Jersey is increasing accessibility and affordability of this tool that can open the door to more effective care.”
Primary sponsors of the legislation (A-4163/S-3098) include Senators Vin Gopal and Troy Singleton and Assembly Members Shavonda Sumter, Gary Schaer, and Shama Haider.
“With this bill now law, we are removing a major obstacle to care and providing New Jersey patients access to essential, evidence-based biomarker testing,” said Gopal. “No one should be forced to choose between their health and financial struggles. This law will save lives, improve outcomes, and ultimately lower healthcare costs for families across the state.”
“Acting Governor Way’s signature of this legislation will add our state to the dozens of states that have expanded insurance coverage for this important form of testing,” said Singleton. “Through this law, both the identification and treatment of cancers will be improved, ensuring New Jerseyans have access to the most effective healthcare possible and saving lives.”
“Everyone deserves access to high-quality medical care, without being held back by financial barriers,” said Sumter. “This legislation is transformational. By requiring health insurers to cover biomarker testing, we are not only breaking down long-standing barriers to care but also giving patients access to potentially life-saving information. It empowers individuals to make informed decisions about their health and opens the door to more personalized, effective treatment. I’m proud to see this critical bill signed into law and remain steadfast in my commitment to the advocates who have fought tirelessly for equitable access to this essential testing.”
“It is crucial to expand access to personalized treatment through biomarker testing,” said Schaer. “Often times, access to patient specific treatment is not always available to patients under their insurance plan and Medicaid. By guaranteeing insurance coverage, the passage of A4163 will combat healthcare disparities and ensures that all patients receive the quality care they deserve.”
“When patients are faced with uncertainty about their health, the last thing they should have to worry about is whether their insurance will cover the necessary tests that could lead to a diagnosis,” said Haider. “A4163 is about providing people with that peace of mind, ensuring they have access to the biomarker testing, regardless of their financial situation.”
