An Act relative to patient access to biomarker testing to provide appropriate therapy

SD 532 requires health insurers and government health plans to cover biomarker testing for diagnosis, treatment, and monitoring of diseases when supported by specific evidence, including FDA approvals, clinical guidelines, or CMS determinations. It directly affects patients enrolled in Commonwealth group insurance (e.g., state employees) and Medicaid beneficiaries. The bill mandates coverage without unnecessary disruptions (like multiple biopsies) and sets strict timelines: insurers must approve or deny prior authorization requests within 72 hours (24 hours for urgent cases), with requests deemed approved if no response is received. Patients and providers also gain access to clear processes for appealing coverage denials.