Expert-guidance and tips for implementing mandate-compliant utilization management

Numerous US states have passed laws mandating expanded insurance coverage for biomarker tests. However, commercial insurers are confused with how to adapt their policies to these new and ambiguous regulations.  

A one-size fits all approach won’t work. Whether your plan operates in states that have yet to enact legislation or in those where law has been passed, there are actions you can to take.

Watch this recorded webinar to unpack the intricacies of  biomarker legislation with clear guidance on how to navigate:

• Variability in legislative definitions and apply professional society guideline hierarchies (like NCCN, FDA, CMS).
• Specific utilization cost implications for commercial and Medicaid plans, highlighting potential increases in per member per month costs (PMPM) and issues with coding practices. 
• Operationalizing coverage to align with clinical aspects of mandates, managing increased utilization without overwhelming costs.

Biomarker legislation is still in its infancy, promising continual changes and evolution. Don’t try to travel this murky terrain alone.

Access our expert insights to stay ahead of the curve and keep your health plan compliant.

Fill out the form to get started now with the right tools to ensure high standards of care today for a thriving and profitable tomorrow.