The Lead

Pa. lawmaker proposes expanded coverage for biomarker testing

By: - June 2, 2023 7:16 am
The ceiling of the main Rotunda inside Pennsylvania’s Capitol building. May 24, 2022. Harrisburg, Pa. (Photo by Amanda Berg, for the Capital-Star).

The ceiling of the main Rotunda inside Pennsylvania’s Capitol building. (Photo by Amanda Berg for the Capital-Star).

A Pennsylvania lawmaker has proposed expanded access to biomarker testing, hoping to connect patients with more effective and personalized treatment plans.

Sen. Devlin Robinson, R-Allegheny, plans to draft legislation requiring that state-regulated insurance plans — including Medicaid — offer biomarker coverage “supported by clinical practice guidelines or peer-reviewed scientific evidence.” The testing uses samples to check for signs that someone could be at risk for developing cancer or another disease.

Results can help plan treatment, assess effectiveness, and predict future outcomes.

“Currently, many insurance plans cover some biomarker testing for some patients, but we have learned that many people get behind because of financial barriers,” Robinson wrote in a memo seeking legislative support. “These patients are unable to receive this individualized, targeted treatment that helps them live longer and better lives.”

The American Cancer Society Cancer Action Network has pushed states to expand insurance coverage of biomarker testing, saying advancements in precision medicine can improve patient outcomes and limit disparities in cancer outcomes by race, ethnicity, income, and geography.

Georgia House public health chair pushes for insuring earlier cancer screening, biomarker testing

Earlier this year, Democratic Gov. Josh Shapiro signed bipartisan legislation enhancing insurance coverage for breast cancer screening and genetic testing.

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