Coverage of exome sequence testing.

49-20-419. Coverage of exome sequence testing.

(1) As used in this section, "exome sequence testing" means a genomic technique for sequencing the genome of an individual for diagnostic purposes.

(2) Beginning July 1, 2019, the program shall provide coverage for exome sequence testing:

(a) for a covered individual within the state risk pool who:

(i) is younger than 21 years of age; and

(ii) who remains undiagnosed after exhausting all other appropriate diagnostic-related tests;

(b) performed by a nationally recognized provider with significant experience in exome sequence testing;

(c) that is medically necessary; and

(d) at a rate set by the program.