H 4339
An Act relative to patient access to biomarker testing to provide appropriate therapy
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- Passed House
- Passed Senate
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Bill overview
This bill aims to improve patient access to biomarker testing, which can help doctors determine the most effective treatment for various diseases. It establishes definitions for key terms like ‘biomarker,’ ‘biomarker testing,’ and ‘consensus statements,’ and outlines criteria for coverage, including FDA approvals, CMS guidelines, and nationally recognized clinical practice guidelines. The bill also addresses the timeliness of prior authorization decisions and ensures patients and providers have access to a clear process for appealing coverage denials.
Key provisions
- Defines key terms: ‘biomarker,’ ‘biomarker testing,’ ‘consensus statements,’ and ‘nationally recognized clinical practice guidelines.’
- Requires coverage for biomarker testing when supported by medical and scientific evidence, including FDA approvals, CMS guidelines, and clinical practice guidelines.
- Establishes a timeframe of 72 hours for prior authorization decisions, with a 24-hour timeframe for urgent cases.
- Mandates a clear and accessible process for patients and providers to request exceptions to coverage policies.
- Expands coverage to include Commonwealth employees, Medicaid enrollees, and individuals with group health plans.
- Limits disruptions in care by minimizing the need for multiple biospecimen samples.
- Requires insurers to notify patients, providers, and authorization requesters within specified timeframes regarding prior authorization decisions.
- Ensures access to a clear process for appealing adverse utilization review determinations.
Who is affected
Sponsors
Official sponsors from legislative records.
Primary sponsor
Joint Committee on Financial Services
Cosponsors
Adrian C. Madaro
Adrianne Pusateri Ramos
Amy Mah Sangiolo
Arguments in favor
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Bill H.4339 194th (Current)
An Act relative to patient access to biomarker testing to provide appropriate therapy
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Bill Information
Bill Information
Sponsor: Joint Committee on Financial Services Status: Referred to House Committee on Ways and Means
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Bill History Cosponsors Committee Vote Fiscal Note Committee Summary
Bill History
Displaying 4 actions for Bill H.4339
| Date | Branch | Action |
| 7/31/2025 | House | Reported from the committee on Financial Services |
| 7/31/2025 | House | New draft of H1227 |
| 7/31/2025 | House | Reported favorably by committee and referred to the committee on Health Care Financing |
| 12/4/2025 | House | Committee recommended bill ought to pass and referred to the committee on House Ways and Means |
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