New Jersey Bulletin 26-08 provides critical compliance guidance for P.L. 2025, c. 49, which mandates coverage for biomarker precision medical testing by all health carriers in New Jersey. The bulletin clarifies that carriers must cover biomarker tests when any one of five statutory criteria is met (FDA approval, FDA drug labeling, CMS coverage determinations, or nationally recognized clinical practice guidelines), and may not layer additional coverage criteria. Carriers must apply the least restrictive criteria when multiple are satisfied, limit disruption in care, and update their medical policies to explicitly reflect the Act. The law already applies to policies issued on or after July 22, 2025, making this an immediate compliance priority. Non-compliance may result in enforcement action.
NJ: Biomarker Testing Coverage (26-08)
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