The proper translation of “We don't know” in this context is Yes. I.e., US third-party payers will almost certainly require biopsies to reimburse for an estimated $20K/yr chronic, rest-of-life therapy for NASH—even if biopsies are not explicitly mandated in the FDA label (which remains to be seen).
ICPT spent most of today’s 3.5-hour webcast arguing that biopsies aren’t needed to treat NASH. This in itself ought to be a flag for investors.