October 6, 2022
Starting January 1, 2023, prior authorization will be waived for certain biomarker testing for Washington members living with cancer. The cancer must be stage III or IV, or it has come back after treatment, not responded to treatment, or spread throughout the body. Biomarker testing looks for changes to genes or proteins related to cancer.
AIM Specialty Health® normally reviews for biomarker (genetic) testing. Retrospective review may still be performed for these tests. Prior authorization is still required for these tests when ordered for other reasons. In these situations, continue to submit requests through the AIM portal.