Health plans would cover genetic counseling and cancer-risk testing

Health plans would cover genetic counseling and indicated genetic testing from certified providers. Coverage would include all counseling costs and indicated gene testing for people whose personal or family cancer history shows increased risk of harmful gene changes, as assessed with a clinical risk assessment tool. Testing must be indicated after genetic counseling. Providers must be certified by an accrediting body recognized by Missouri's Department of Commerce and Insurance. The coverage requirement would apply to plans delivered, issued for delivery, continued, or renewed on or after January 1, 2027.

Health plans would generally cover the required services without deductibles, copays, or similar patient charges. This rule would apply to the genetic counseling and testing required by this section. For high-deductible plans that qualify for health savings accounts, the no-charge rule would apply only after the federal minimum deductible if needed to preserve account eligibility. Services that count as preventive care under the cited federal rule would remain covered without patient charges before that deductible is met.

Health plans and insurers would be barred from using covered genetic test results or counseling in insurance decisions. The restriction would cover eligibility, premiums, coverage limits, renewals, and other decisions about whether and on what terms to insure someone. Plans and insurers also could not request approval to use this information. A violation would count as a violation of section 375.1303.