Indiana Senate Bill 273-Biomarker Testing Coverage

April 30, 2024

On March 11, 2024, Governor Eric Holcomb signed into law Senate Bill 273.  This bill had overwhelming support in both the House and the Senate.  This legislation will ensure that more insurance plans in Indiana will now cover biomarker testing, which will be a turning point in the fight against cancer, said one Senator. Effective July 1, 2024 this law requires health insurance plans to provide coverage for biomarker testing in the following cases:

•    Diagnosis
•    Treatment
•    Appropriate management
•    Ongoing treatment of diseases or conditions where biomarker testing is supported by medical and scientific evidence

This also applies to Medicaid risk-based managed care plans, as well as requiring the office of Medicaid policy and planning to provide biomarker testing within the Medicaid program.  This does not include biomarker testing for screening purposes.

The bill also speaks to prior authorizations, required by health insurance companies prior to the approval of the testing.  The bill states that if a prior authorization is required, the plan must approve or deny the request and notify the covered individual within five business days for non-urgent cases and not more than 48 hours in the case of an emergent request.