LIVE OVER ZOOM • APRIL 8Â
Addressing the Precision Medicine Gatekeeper
We’re going to examine how insurance coverage policies determine access to genetic and biomarker testing, and why patients in some states receive precision-guided care while others face delays or denials. Drawing from legal and advocacy experience in both leading and emerging policy states, Delphine and Jessica will clarify how coverage rules are written, applied and challenged. You’ll leave with a clear understanding of the policy landscape and practical ways to engage in conversations that influence access.
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LIVE OVER ZOOM • APRIL 8
We’re going to examine how insurance coverage policies determine access to genetic and biomarker testing, and why patients in some states receive precision-guided care while others face delays or denials. Drawing from legal and advocacy experience in both leading and emerging policy states, Delphine and Jessica will clarify how coverage rules are written, applied and challenged. You’ll leave with a clear understanding of the policy landscape and practical ways to engage in conversations that influence access.
3 Things You'll Take Away
Insurance coverage decisions increasingly determine whether precision medicine is used or delayed.
Understand how insurance determines access
Learn how coverage policies, prior authorization requirements and medical necessity criteria shape whether genetic and biomarker testing is approved.
See why some states lead while others lag
Understand how state-level laws influence insurance coverage, and why patients in some regions have faster access to precision-guided care.
Learn how to influence coverage policy
Discover where providers and patients can engage to ensure coverage policies reflect modern clinical standards.
3 Things You'll Take Away With You
Every denial pulls a medical provider further away from patient care and deeper into administrative conflict.Â
Understand how insurance determines access
Learn how coverage policies, prior authorization requirements and medical necessity criteria shape whether genetic and biomarker testing is approved.
See why some states lead while others lag
Understand how state-level laws influence insurance coverage, and why patients in some regions have faster access to precision-guided care.
Learn how to influence coverage policy
Discover where providers and patients can engage to ensure coverage policies reflect mo
THE INSURANCE COVERAGE FRAMEWORK
Genetic and biomarker testing are part of modern clinical care, but coverage is determined by insurance policy, not scientific capability. Most insurers rely on internal coverage policies, medical necessity criteria and guideline interpretation to decide whether testing is approved. These policies vary widely between insurers and are often updated slowly, which can delay access to tests that are already supported by clinical evidence.
For providers and patients, this creates uncertainty. A test that is routine in one setting may require extensive authorization or face denial in another. Understanding how insurers evaluate coverage is the first step in identifying where access barriers originate and how they can be addressed.
THE STATE-BY-STATE POLICY DIVIDE
In the absence of uniform federal standards, states have taken different approaches to addressing biomarker and genetic testing coverage. Some states have enacted laws requiring insurers to cover testing when supported by recognized clinical guidelines. Others rely entirely on insurer discretion, which can result in inconsistent access and delayed care.
This state-level variation has created a patchwork system, where access to precision medicine is influenced as much by geography as by clinical need. Recognizing how state policy shapes coverage helps advocates, providers and patients identify opportunities to improve access and align insurance practices with modern standards of care.
REGISTER NOWTHE INSURANCE COVERAGE FRAMEWORK
Genetic and biomarker testing are part of modern clinical care, but coverage is determined by insurance policy, not scientific capability. Most insurers rely on internal coverage policies, medical necessity criteria and guideline interpretation to decide whether testing is approved. These policies vary widely between insurers and are often updated slowly, which can delay access to tests that are already supported by clinical evidence.
For providers and patients, this creates uncertainty. A test that is routine in one setting may require extensive authorization or face denial in another. Understanding how insurers evaluate coverage is the first step in identifying where access barriers originate and how they can be addressed.
THE STATE-BY-STATE POLICY DIVIDE
In the absence of uniform federal standards, states have taken different approaches to addressing biomarker and genetic testing coverage. Some states have enacted laws requiring insurers to cover testing when supported by recognized clinical guidelines. Others rely entirely on insurer discretion, which can result in inconsistent access and delayed care.
This state-level variation has created a patchwork system, where access to precision medicine is influenced as much by geography as by clinical need. Recognizing how state policy shapes coverage helps advocates, providers and patients identify opportunities to improve access and align insurance practices with modern standards of care.
REGISTER NOWGuided by Experience and Policy InsightÂ
Jessica Baladad
Founder of Feel For Your LifeÂ
After a breast cancer diagnosis at 33, Jessica turned her experience into a mission to change how women advocate for their healthcare.
In 2021, the seven-year cancer survivor created Feel For Your Life, a mobile AI-powered app that helps women perform self exams, understand screening and advocate for their breast health. To date, the app has been downloaded more than 200,000 times worldwide.
Since launching the app, Jessica has helped draft Tennessee legislation focused on risk-reducing cancer education, driven state and federal lawmakers to co-sponsor reforms targeting PBMs and copay accumulators and testified against Certificate of Need laws. She works alongside patients and professionals to sharpen voices, shape messages and elevate their role in conversations that directly affect health outcomes.
Her work and perspectives have been featured in campaigns with the NFL, on Good Morning America, USA Today and in media outlets around the world, amplifying conversations that help patients and providers cut through bureaucracy and move care forward.
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Delphine O'Rourke
CEO of dotted...
For over 20 years, Delphine O'Rourke has been transforming the healthcare industry and advocating for women – as a healthcare executive, policy expert, lawyer, investor, and educator. She is CEO of Dotted, Inc. an advisory firm focused on mergers, acquisitions, and partnerships as well as Founder & Partner of 1928 LAW, a boutique firm for the healthcare industry. Delphine is also the co-host of The Conversation Lounge podcast and teaches at Columbia Law School.
Previously, Delphine was a partner at Goodwin where she created and chaired the world’s first law firm practice dedicated to the women’s health industry. Prior to returning to private practice, she spent over a decade as a healthcare executive, attorney, and advocacy lead for Ascension – one of the largest and most complex health companies and health systems in the US.
Due to her work where women’s health, innovation and policy come together, she is a sought-after speaker on leadership, the future of the women's health industry, and investment in women’s health. Delphine serves on the boards of multiple women's health companies and is regularly recognized for her accomplishments (Best Lawyers in America®, The Financial Times, WoW). She is a graduate of Georgetown University and Columbia Law School.
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Guided by Experience and Policy InsightÂ
Jessica Baladad
Founder of Feel For Your LifeÂ
After a breast cancer diagnosis at 33, Jessica turned her experience into a mission to change how women advocate for their healthcare.
In 2021, the seven-year cancer survivor created Feel For Your Life, a mobile AI-powered app that helps women perform self exams, understand screening and advocate for their breast health. Built by a breast cancer patient, the app has been downloaded more than 100,000 times worldwide.
Since launching the app, Jessica has helped draft Tennessee legislation focused on risk-reducing cancer education, driven state and federal lawmakers to co-sponsor reforms targeting PBMs and copay accumulators and testified against Certificate of Need laws. She works alongside patients and professionals to sharpen voices, shape messages and elevate their role in conversations that directly affect health outcomes.
Her work and perspectives have been featured in campaigns with the NFL, on Good Morning America, USA Today and in media outlets around the world, amplifying conversations that help patients and providers cut through bureaucracy and move care forward.
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Delphine O'Rourke
CEO of dotted...
For over 20 years, Delphine O'Rourke has been transforming the healthcare industry and advocating for women – as a healthcare executive, policy expert, lawyer, investor, and educator. She is CEO of Dotted, Inc. an advisory firm focused on mergers, acquisitions, and partnerships as well as Founder & Partner of 1928 LAW, a boutique firm for the healthcare industry. Delphine is also the co-host of The Conversation Lounge podcast and teaches at Columbia Law School.
Previously, Delphine was a partner at Goodwin where she created and chaired the world’s first law firm practice dedicated to the women’s health industry. Prior to returning to private practice, she spent over a decade as a healthcare executive, attorney, and advocacy lead for Ascension – one of the largest and most complex health companies and health systems in the US.
Due to her work where women’s health, innovation and policy come together, she is a sought-after speaker on leadership, the future of the women's health industry, and investment in women’s health. Delphine serves on the boards of multiple women's health companies and is regularly recognized for her accomplishments (Best Lawyers in America®, The Financial Times, WoW). She is a graduate of Georgetown University and Columbia Law School.
