AN ACT CONCERNING COVERAGE OF PHARMACOGENOMICS TESTING UNDER THE HUSKY HEALTH PROGRAMS.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (NEW) (Effective July 1, 2018) (a) For purposes of this section, (1) "pharmacogenomics" means the study of how an individual's genetic makeup, or genotype, affects the body's response to prescription drugs, and (2) "medically necessary" means a determination by a treating primary care practitioner made in accordance with section 17b-259b of the general statutes.

(b) The Commissioner of Social Services shall provide Medicaid coverage to the extent permissible under federal law for pharmacogenomics tests determined to be medically necessary. The commissioner shall not require prior authorization for medically necessary pharmacogenomics tests for persons being treated for (1) behavioral disorders, (2) psychiatry disorders, (3) cardiovascular disorders, and (4) chronic pain.

(c) In contracting for the provision of pharmacogenomics tests, the commissioner may give preference to any Medicaid-enrolled laboratory provider that offers a discounted price for such tests. If necessary, the commissioner may amend the Medicaid state plan to provide coverage for pharmacogenomics tests.

Statement of Purpose:

To require Medicaid coverage without prior authorization for certain pharmacogenomics tests determined medically necessary by a treating primary care practitioner.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]