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Section 419 - Coverage of exome sequence testing.

UT Code § 49-20-419 (2019) (N/A)
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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.

(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.

(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;

(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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