California Welfare and Institutions Code

§ 14132.09

WIC § 14132.09 Effective Jan 1, 2024Div. 9 · Part 3 · Ch. 7 · Art. 4

Statute text

(a)By July 1, 2024, biomarker testing, as specified in this section, is a covered benefit, subject to utilization controls and medical necessity requirements, as described in Section 14059.5. Biomarker testing shall be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of a Medi-Cal beneficiary’s disease or condition to guide treatment decisions. Coverage shall include biomarker tests that meet any of the following:

(1)A labeled indication for a test that has been approved or cleared by the United States Food and Drug Administration (FDA) or is an indicated test for an FDA-approved drug.

(2)A national coverage determination made by the federal Centers for Medicare and Medicaid Services, to the extent allowed under the Medicaid program.

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Legislative history

Added by Stats. 2023, Ch. 401, Sec. 3. (SB 496) Effective January 1, 2024.