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HB 484

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) Introduced by Brock Martin

Tennessee would require health insurers and Medicaid to cover biomarker testing from 2026 onward, expanding diagnostic access but raising costs and leaving test definitions undefined.

Transmitted to Governor for his action.
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Bill Summary · HB 484

Legislative bill overview

HB 484 mandates that health benefit plans in Tennessee, including TennCare (the state Medicaid program), cover biomarker testing starting January 1, 2026. The bill amends state insurance law to require this coverage without specifying which biomarkers, testing types, or clinical contexts are included.

Why is this important

Biomarker testing can identify disease risk, aid early diagnosis, and guide personalized treatment decisions, potentially improving health outcomes. However, mandating coverage without clear parameters affects insurance premiums, state Medicaid costs, and determines which tests patients can access—making this a significant healthcare policy and budget decision.

Potential points of contention

  • Undefined scope: The bill doesn't specify which biomarkers or tests qualify, potentially requiring coverage of unproven or experimental tests alongside established ones
  • Cost implications: Mandated coverage increases insurance premiums for consumers and state expenses for TennCare, with no fiscal impact analysis provided
  • Clinical necessity standards: Unclear whether coverage applies to all patients or only those meeting specific clinical criteria, affecting appropriate utilization
  • Implementation timeline: January 1, 2026 deadline may be insufficient for plans to establish testing protocols and coverage frameworks

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

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