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. |
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Terms Used In Utah Code 49-20-419
- Covered individual: means an employee and the employee's dependents eligible for coverage under this chapter. See Utah Code 49-20-102
- Program: means the Public Employees' Benefit and Insurance Program. See Utah Code 49-20-102
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(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. |
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Enacted by Chapter 320, 2019 General Session