Robert (Bob) R. Hearn, Member of the Firm in the Health Care & Life Sciences and Litigation & Business Disputes practices, in the firm’s Tampa and St. Petersburg offices, was quoted in Health Payer Specialist, in “Concerns Mount as More States Adopt Biomarker Laws,” by Rachel Dalloo. (Read the full version – subscription required.)

Following is an excerpt:

More than a dozen states across the country have enacted legislation requiring payers start covering the expensive biomarker testing used in cancer and other specialty treatments.

More may be on the way.

Biomarker tests, which are also called genomic tests, are used to help oncologists determine which drug regimen or other treatment would be appropriate for each specific case of cancer. More than half of the oncology drugs introduced in the past five years require biomarker testing prior to their use.

Aside from treating cancer-related illnesses, the tests also play a role in combating diseases such as arthritis and diabetes. …

The changing legal landscape does give payers discretion. “The laws by and large don’t just say you have to cover any biomarker testing that anybody in the universe comes up with – it has to be legitimate. There are parameters and criteria for what constitutes a medically necessary test,” said Robert Hearn, an attorney for health care & life sciences at Epstein Becker Green.

Jump to Page

Privacy Preference Center

When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalized web experience. Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.

Strictly Necessary Cookies

These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms. You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.

Performance Cookies

These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.