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SB 435

Insurance, Health, Accident - As introduced, requires health benefit plans and TennCare health benefit plans to cover biomarker testing on and after January 1, 2026. - Amends TCA Title 56 and Title 71.

114th Regular Session (2025-2026)

Tennessee requires all health insurers and TennCare to cover biomarker testing starting 2026, expanding access to diagnostic tests but increasing plan costs without defining which specific tests qualify.

Companion House Bill substituted
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Bill Summary · SB 435

Legislative bill overview

SB 435 mandates that all health benefit plans in Tennessee, including TennCare (the state's Medicaid program), must cover biomarker testing starting January 1, 2026. The bill amends state insurance and healthcare laws to establish this coverage requirement across both private and public health plans.

Why is this important

Biomarker testing can help identify disease risk, diagnose conditions earlier, and guide treatment decisions for serious illnesses like cancer and heart disease. Mandating coverage removes potential cost barriers for patients and may improve health outcomes, though it also increases costs that insurers and the state will bear.

Potential points of contention

  • Undefined scope: The bill doesn't specify which biomarker tests qualify for mandatory coverage, creating ambiguity about what insurers must pay for and potentially opening the door to coverage disputes
  • Cost implications: Expanded testing coverage increases premiums for private insurers and state spending for TennCare, which could be substantial depending on test types and utilization rates
  • Medical necessity standards: Unclear guidelines on whether tests are covered for screening, diagnosis, or treatment decisions could lead to inconsistent implementation across plans

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

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