Utah Code 49-20-419. 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.

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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.

Enacted by Chapter 320, 2019 General Session