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S 809

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

194th Legislature (2025-2026) Introduced by Mike Brady and 26 co-sponsors

Massachusetts bill requiring health insurers to cover biomarker testing that identifies which therapies work best for individual patients' diseases, removing cost barriers to personalized treatment.

Hearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual Hearing updated to New End Time
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Bill Summary · S 809

Legislative bill overview

S 809 requires health insurance plans in Massachusetts to cover biomarker testing—diagnostic tests that identify genetic or molecular characteristics of tumors and other conditions—to help determine the most effective drug therapies for patients. The bill aims to ensure patients can access these tests without financial barriers, enabling personalized treatment decisions based on individual disease characteristics.

Why is this important

Biomarker testing has become standard practice in oncology and increasingly in other fields, allowing doctors to match patients with targeted therapies that are more likely to work for their specific condition. Without insurance coverage mandates, these tests can cost hundreds to thousands of dollars out-of-pocket, effectively preventing many patients from receiving precision medicine and forcing them onto less effective broad-spectrum treatments. The bill addresses a gap where coverage policies vary significantly across insurers and can delay critical treatment decisions.

Potential points of contention

  • Cost implications: Insurers argue coverage mandates increase premiums; supporters counter that targeted therapies reduce overall treatment costs by avoiding ineffective drugs and their side effects
  • Medical necessity criteria: Disagreement over which biomarker tests should be covered, whether all recommended tests require pre-authorization, and who determines medical appropriateness (insurers vs. physicians)
  • Access equity: Questions about whether the mandate adequately addresses coverage gaps for underinsured/uninsured patients and whether it applies to all plan types or only certain insurance products

Compiled from official sources — confirm details with the bill’s official record.

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