Coverage of exome sequence testing.

1. Law
2. Utah Code
3. Utah State Retirement and Insurance Benefit Act
4. Public Employees' Benefit and Insurance Program Act
5. Insurance Program
6. 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.

• (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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