Vermont H 136: An act relating to Abenaki trapping licenses

Bill Text

BILL AS INTRODUCED H.136
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VT LEG #379974 v.1
H.136 1
Introduced by Representatives McCann of Montpelier, Cina of Burlington, 2
Hango of Berkshire, Chapin of East Montpelier, Cole of 3
Hartford, Dodge of Essex, Headrick of Burlington, Howard of 4
Rutland City, Krasnow of South Burlington, Labor of Morgan, 5
Logan of Burlington, McGill of Bridport, Minier of South 6
Burlington, Morgan, L. of Milton, Mrowicki of Putney, Nelson 7
of Derby, Pouech of Hinesburg, Priestley of Bradford, 8
Rachelson of Burlington, Stevens of Waterbury, Stone of 9
Burlington, and Taylor of Milton 10
Referred to Committee on 11
Date: 12
Subject: Health; health insurance; Medicaid; biomarker testing 13
Statement of purpose of bill as introduced: This bill proposes to require health 14
insurance and Medicaid coverage for biomarker testing. 15
An act relating to health insurance coverage for biomarker testing 16
It is hereby enacted by the General Assembly of the State of Vermont: 17
Sec. 1. 8 V.S.A. § 4088n is added to read: 18
§ 4088n. COVERAGE FOR BIOMARKER TESTING 19
(a) As used in this section: 20

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VT LEG #379974 v.1
(1) “Biomarker” means a characteristic that is objectively measured and 1
evaluated as an indicator of normal biological processes, pathogenic processes, 2
or pharmacologic responses to a specific therapeutic intervention, including 3
known gene-drug interactions for medications being considered for use or 4
already being administered. Biomarkers include gene mutations, 5
characteristics of genes, and protein expression. 6
(2) “Biomarker testing” means the analysis of a patient’s tissue, blood, 7
or other biospecimen for the presence of a biomarker. Biomarker testing 8
includes single-analyte tests, multiplex panel tests, protein expression analysis, 9
and whole exome, whole genome, and whole transcriptome sequencing. 10
(3) “Consensus statements” means statements developed by an 11
independent, multidisciplinary panel of experts utilizing a transparent 12
methodology and reporting structure and with a conflict of interest policy. 13
These statements are aimed at specific clinical circumstances and the 14
statements are based on the best available evidence for the purpose of 15
optimizing the outcomes of clinical care. 16
(4) “Health insurance plan” means any health insurance policy or health 17
benefit plan offered by a health insurer, as defined in 18 V.S.A. § 9402. The 18
term does not include policies or plans providing coverage for a specified 19
disease or other limited benefit coverage. 20

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VT LEG #379974 v.1
(5) “Nationally recognized clinical practice guidelines” means evidence-1
based clinical practice guidelines developed by independent organizations or 2
medical professional societies utilizing a transparent methodology and 3
reporting structure and with a conflict of interest policy. Clinical practice 4
guidelines establish standards of care informed by a systematic review of 5
evidence and an assessment of the benefits and risks of alternative care options 6
and include recommendations intended to optimize patient care. 7
(b) A health insurance plan shall provide coverage for the services of 8
biomarker testing for the purposes of diagnosis, treatment, appropriate 9
management, and ongoing monitoring of a patient’s disease or condition when 10
the test is supported by medical and scientific evidence, including: 11
(1) labeled indications for a test approved or cleared by the U.S. Food 12
and Drug Administration (FDA); 13
(2) indicated tests for an FDA-approved drug; 14
(3) warnings and precautions on FDA-approved drug labels; 15
(4) Centers for Medicare and Medicaid Services national coverage 16
determinations or Medicare Administrative Contractor local coverage 17
determinations; or 18
(5) nationally recognized clinical practice guidelines and consensus 19
statements. 20

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VT LEG #379974 v.1
(c) The coverage required in subsection (b) of this section shall be provided 1
in a manner that limits disruptions in care, including the need for multiple 2
biopsies or biospecimen samples. 3
Sec. 2. 33 V.S.A. § 1901n is added to read: 4
§ 1901n. MEDICAID COVERAGE FOR BIOMARKER TESTING 5
(a) As used in this section: 6
(1) “Biomarker” means a characteristic that is objectively measured and 7
evaluated as an indicator of normal biological processes, pathogenic processes, 8
or pharmacologic responses to a specific therapeutic intervention, including 9
known gene-drug interactions for medications being considered for use or 10
already being administered. Biomarkers include gene mutations, 11
characteristics of genes, and protein expression. 12
(2) “Biomarker testing” means the analysis of a patient’s tissue, blood, 13
or other biospecimen for the presence of a biomarker. Biomarker testing 14
includes single-analyte tests, multiplex panel tests, protein expression analysis, 15
a