Requiring insurance coverage for biomarker testing

SB 464 requires health insurance plans in West Virginia, including the Public Employees Insurance Act, to cover biomarker testing when ordered by a physician for diagnosis, treatment, or monitoring of a disease, provided the test is medically indicated and has clinical utility. Biomarker testing - such as analyzing tissue or blood samples to identify gene mutations or protein markers that guide treatment decisions - must be based on evidence like FDA approvals, national medical guidelines (e.g., from the National Comprehensive Cancer Network), or Medicare coverage determinations. Insurers must provide a clear online process for appealing coverage denials and avoid requiring multiple biopsies that disrupt care. The bill does not cover routine screening before a diagnosis and mandates the Public Employees Insurance Agency to report implementation costs to the legislature after one year.