Utah Code 49-20-419. Coverage of exome sequence testing
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(1) As used in this section, “exome sequence testing” means a genomic technique for sequencing the genome of an individual for diagnostic purposes.
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:
(2)(a) for a covered individual within the state risk pool who:
(2)(a)(i) is younger than 21 years of age; and
(2)(a)(ii) who remains undiagnosed after exhausting all other appropriate diagnostic-related tests;
(2)(b) performed by a nationally recognized provider with significant experience in exome sequence testing;
(2)(c) that is medically necessary; and
(2)(d) at a rate set by the program.