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MississippiHB 5652026 Regular SessionHouseWALLET

Health benefit plans and Medicaid; require to offer coverage for biomarker testing.

Sponsored By: Sam Creekmore IV

Signed by Governor

Public Health and Human ServicesInsurance

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 5 benefits, 0 costs, 0 mixed.

Health plans must cover biomarker tests

Beginning July 1, 2026, when your health plan starts or renews, it must cover biomarker testing for diagnosis, treatment, management, or monitoring if supported by strong medical evidence. Evidence can include FDA labels, Medicare coverage decisions, or nationally recognized clinical guidelines. Plans active before that date follow these rules at their next renewal. The law also defines key terms like biomarker, biomarker testing, and health benefit plan so it’s clear what is covered.

Medicaid can pay certified community health workers

Starting July 1, 2026, Medicaid can reimburse services by certified community health workers who are employed and supervised by a Medicaid provider. This only occurs if the federal Centers for Medicare and Medicaid Services approves a state plan change, waiver, or other payment model. With approval, more community-based help can be covered for Medicaid members.

Medicaid covers biomarker testing statewide

Beginning July 1, 2026, Medicaid covers biomarker testing under the same evidence standards as other health plans. Within 60 days after that date, Medicaid updates its fee schedule to add the needed CPT and PLA billing codes so providers can bill.

Clear biomarker policies and fewer biopsies

Health plans must post their biomarker testing policies online. Initial updates are due within 60 days after enactment, and future changes must be posted at least 30 days before they take effect. Coverage must be provided in ways that avoid repeat biopsies or extra samples. The Mississippi Insurance Department can audit plans to check compliance. These rules apply beginning July 1, 2026.

Faster approvals and fair biomarker appeals

Starting July 1, 2026, plans must offer an easy, clearly posted way to request coverage exceptions or appeal denials for biomarker tests. If prior authorization is required, they must decide within state time limits for urgent and nonurgent cases and notify you and your provider. Your doctor, the lab, you, or your representative can file the request. If a test that meets the law’s evidence standards is denied, the plan must give a detailed written reason.

Sponsors & Cosponsors

Sponsor

  • Sam Creekmore IV

    House

Cosponsors

  • Christopher M. Bell

    House

  • Becky Currie

    Republican • House

  • Casey Eure

    Republican • House

  • Kevin Felsher

    Republican • House

  • Jay McKnight

    Republican • House

  • Jansen T. Owen

    Republican • House

  • Omeria Scott

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 167 • No: 0

Senate vote • 3/4/2026

Passed

Yes: 51 • No: 0

House vote • 1/28/2026

Passed As Amended

Yes: 116 • No: 0

Actions Timeline

  1. Approved by Governor

    3/16/2026legislature

  2. Enrolled Bill Signed

    3/9/2026Senate

  3. Enrolled Bill Signed

    3/6/2026House

  4. Returned For Enrolling

    3/5/2026Senate

  5. Passed

    3/4/2026Senate

  6. Title Suff Do Pass

    2/26/2026Senate

  7. Referred To Insurance

    2/18/2026Senate

  8. Transmitted To Senate

    1/29/2026House

  9. Passed As Amended

    1/28/2026House

  10. Amended

    1/28/2026House

  11. Title Suff Do Pass

    1/22/2026House

  12. DR - TSDP: IN To PH

    1/22/2026House

  13. DR - TSDP: PH To IN

    1/22/2026House

  14. Referred To Public Health and Human Services;Insurance

    1/13/2026House

Bill Text

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