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SB 391

AN ACT REQUIRING HEALTH INSURANCE COVERAGE FOR BIOMARKER TESTING.

2025 Regular Session Introduced by Jeff Gordon

Connecticut would require health insurers to cover biomarker testing for disease diagnosis, removing prior authorization barriers to improve patient access to targeted diagnostic tools.

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Bill Summary · SB 391

Legislative bill overview

SB 391 mandates that health insurance plans in Connecticut cover biomarker testing—diagnostic tests that identify biological markers associated with diseases, particularly cancers. The bill requires insurers to include these tests in their coverage without imposing barriers like prior authorization requirements that might delay access.

Why is this important

Biomarker testing helps oncologists and other physicians identify which patients will benefit from specific targeted treatments, potentially improving treatment outcomes and avoiding ineffective therapies. Without insurance coverage mandates, cost becomes a barrier to accessing these increasingly important diagnostic tools, particularly for uninsured or underinsured patients who might otherwise forgo testing.

Potential points of contention

  • Cost implications: Insurance carriers will argue that expanded coverage mandates increase premiums and administrative costs, which may be passed to employers and consumers
  • Medical necessity standards: Debate over which specific biomarker tests should be covered, as new tests emerge constantly and not all have equivalent clinical validation or necessity
  • Prior authorization trade-offs: While removing prior authorization speeds access, insurers use this process to prevent unnecessary testing; removing it entirely could increase costs without corresponding medical benefit verification

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

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