Oklahoma Expands Insurance Coverage to Evidence-Based Cancer Imaging and Genetic Testing

In April 2025, Oklahoma passed SB109. This legislation requires health insurance companies to cover certain genetic testing and cancer imaging, services for which there are currently no required deductibles.

The Value of Clinical Genetic Testing

The legislation defines clinical genetic testing as testing an individual’s genes for mutations. These mutations, which can be both personal and prevalent in a family’s history, can increase the risk of developing cancer. One of the most common genetic mutations is in the BRCA1 and BRCA2 genes which increase the risk of developing breast cancer to increase by 60 percent, versus the general population’s 13 percent chance. To determine when genetic testing would be beneficial, Oklahoma is leveraging the work of the biomedical community including the National Comprehensive Cancer Network’s (NCCN) clinical practice recommendations. NCCN has four categories of evidence and consensus:

• Category 1: Based upon high-level evidence (≥1 randomized phase 3 trials or high-quality, robust meta-analyses) with uniform NCCN consensus (at least 85% of the panel in support)
• Category 2A: Based upon lower-level evidence with uniform NCCN consensus (at least 85% of the panel in support
• Category 2B: Based upon lower-level evidence, with less NCCN consensus (at least 50% of the panel in support)
• Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate.

Oklahoma is covering any testing in categories 2A or higher. In using the cancer community as a resource, Oklahoma can keep patients up to date on best practices, avoiding frequent revisions of the bill’s language.

The Importance of Early Detection

The bill also addresses cancer imaging, which is part of both screening and treatment, catching cancer early and tracking its spread and reaction to treatment. NCCN’s category 2A and higher recommendations for cancer imaging are also being followed. By requiring health insurance to cover cancer imaging and genetic testing, this bill will improve health outcomes for patients in Oklahoma through better access to personalized medicine and precision oncology.