Insurance, Health, Accident - As enacted, requires a health insurer that issues, amends, delivers, or renews a contract or agreement for a health benefit plan to take effect on or after January 1, 2027, to include coverage for biomarker testing; requires a TennCare health benefit plan that is issued, amended, or renewed on or after January 1, 2027, to provide coverage for biomarker testing when medically necessary. - Amends TCA Title 56 and Title 71.

SB 435 requires Tennessee health insurers and TennCare to cover biomarker testing for diagnosis, treatment, or monitoring of diseases starting January 1, 2026. Biomarker testing - medical tests analyzing genes, proteins, or other biological markers - must be covered when supported by FDA approvals, clinical guidelines, or evidence-based standards. Insurers must process prior authorization requests within 24 hours for urgent cases and 72 hours for non-urgent ones, while ensuring coverage avoids repeated biopsies. This affects all private health benefit plans and TennCare enrollees by mandating coverage for specific, evidence-based diagnostic and treatment tests.