Senate Commerce Committee Statement to Senate, No. 3098 (State of New Jersey, December 12, 2024)

Summary

Senate Commerce Committee statement to Senate, No. 3098 with committee amendments, State of New Jersey, dated December 12, 2024. The committee reports favorably and with committee amendments Senate Bill No. 3098, which as amended requires health insurers to cover biomarker testing. The statement says carriers are to cover testing for diagnosis, treatment, appropriate management, or ongoing monitoring of an individual’s disease or condition when the test is supported by medical and scientific evidence. It says the committee amended the bill to require carriers to provide biomarker testing pursuant to guidelines and timeframes in the “Ensuring Transparency in Prior Authorization Act” if utilization review is required. As amended and reported, the bill is identical to Assembly Bill No. 4163 (1R).

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     SENATE COMMERCE COMMITTEE

                     STATEMENT TO

                   SENATE, No. 3098
                    with committee amendments



 STATE OF NEW JERSEY
                   DATED: DECEMBER 12, 2024

     The Senate Commerce Committee reports favorably and with
committee amendments Senate Bill No. 3098.
     As amended, this bill requires health insurers to cover biomarker
testing. Under the bill, health insurance carriers (including health
service corporations, hospital service corporations, medical service
corporations, commercial individual and group health insurers, health
maintenance organizations, entities contracted to administer health
benefits in connection with the State Health Benefits Program and
School Employees’ Health Benefits Program, and Medicaid) are to
cover testing for the purposes of diagnosis, treatment, appropriate
management, or ongoing monitoring of an individual’s disease or
condition when the test is supported by medical and scientific
evidence. The evidence includes, but is not limited to: (1) labeled
indications for an FDA-approved or -cleared test; (2) indicated tests
for an FDA-approved drug; (3) warnings and precautions on FDA-
approved drug labels; (4) Centers for Medicare and Medicaid Services
National Coverage Determinations or Medicare Administrative
Contractor Local Coverage Determinations; or (5) nationally
recognized clinical practice guidelines and consensus statements.
Coverage is to be provided in a manner that limits disruption,
including multiple biopsies or biospecimen samples, in the care of an
individual.
     The bill also stipulates that utilization review decisions concerning
coverage provided under the bill are to be made in accordance with
guidelines and timeframes already present in current law.
     As amended and reported by the committee, Senate Bill No. 3098
is identical to Assembly Bill No. 4163 (1R).

COMMITTEE AMENDMENTS
   The committee amended the bill to:
   (1) require carriers to provide biomarker testing to covered persons
pursuant to guidelines and timeframes set forth in the “Ensuring
Transparency in Prior Authorization Act,” if utilization review is
required;
   (2) remove the definition of “consensus statement;” and
   (3) make a technical correction.


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