Bill
AB 382
Expands and standardizes insurance coverage to include biomarker testing for any medical condition when supported by medical or scientific evidence, beyond cancer-focused medical n
Status & timeline
- Introduced: February 3, 2025.
- Passed and enrolled by the Legislature; approved by the Governor and chaptered as Chapter 555, Statutes of 2025 (Governor approval date: October 10, 2025).
- Effective for policies delivered, issued for delivery, or renewed on or after January 1, 2026 (policy language: includes coverage as of that date).
Purpose
- Expand and standardize health insurance coverage for biomarker testing. The bill removes prior limits that required such testing to be both (a) “medically necessary” and (b) limited to cancer care. Instead it requires coverage of biomarker testing for the diagnosis, treatment, management, and ongoing monitoring of any medical condition or disease when supported by medical or scientific evidence.
Key provisions
- Required coverage: Insurers issuing individual and group health insurance policies must cover biomarker testing for a medical condition or disease when supported by medical/scientific evidence. Supported evidence may include:
- FDA-labeled indications for a test or drug;
- National or local Medicare coverage determinations;
- Nationally recognized clinical practice guidelines or independent consensus statements.
- Definitions: the bill defines key terms including “biomarker,” “biomarker testing” (explicitly covering single-analyte tests, multiplex panels, whole genome/exome/transcriptome sequencing), “consensus statement,” and “nationally recognized clinical practice guidelines.”
- Prior authorization and timelines: if prior authorization is required, insurers must respond within 24 hours for urgent requests and within 72 hours for non-urgent requests.
- Administrative processes: insurers must:
- Provide coverage so as to limit care disruptions and avoid unnecessary repeat specimen collection;
- Maintain a clear, readily accessible process (including an online posting) for providers or insureds to request exceptions to coverage exclusions and to appeal denials.
- Permitted exclusions/limits: the statute does not require coverage for:
- Screening purposes;
- Tests performed by a provider for whom the testing is outside that provider’s scope of practice, training, or experience;
- (Current draft also allows exclusion for tests performed by providers or facilities that do not participate in the insurer’s network — i.e., out‑of‑network providers — subject to statutory language).
- Relationship to existing law: the bill amends and expands multiple state insurance statutes (e.g., NRS 689A.0446 and related sections as amended).
Who is affected
- Private insurers (individual and group policies) and public plans governed by the cited NRS provisions (including programs addressed under existing law). Providers ordering biomarker tests and patients who may need them will be directly affected by broadened coverage rules and faster prior authorization timelines.
Potential fiscal and administrative impacts
- The bill includes a fiscal note indicating it may affect state and local government costs and contains an identified unfunded mandate (per legislative analysis). Implementation may require insurers and public plans to update policies, member/provider communications, prior authorization processes, and network administration. Local governments and state agencies that operate health plans may incur additional costs.
Notes
- The bill removes the explicit statutory requirement that a provider must first determine a test is “medically necessary” for coverage to apply; coverage depends instead on whether the testing is supported by specified forms of medical/scientific evidence.
Compiled from official sources — confirm details with the bill’s official record.
Sign in to ask a question.
