The bill would require Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) to cover certain cancer diagnostic and laboratory tests, including DNA and RNA sequencing, and explanations of test results. Coverage would be limited when a test reports the same genetic information: generally once at diagnosis, once after a recurrence, and as needed for treatment planning or monitoring. The bill would also create an education program about genomic testing for physicians and the public.
If you have cancer and are covered by Medicare, Medicaid, or CHIP, the bill would provide coverage for the specified tests, subject to its terms. Medicare coverage would begin six months after enactment. Medicaid coverage would generally begin January 1, 2027, and CHIP coverage would begin January 1, 2025, as stated in the bill. The education program would explain genomic testing and the role of genetic counselors.
The bill does not provide an estimate of total program costs. For covered Medicare tests, it sets payment at 80 percent of the lower of the test’s actual charge or a specified Medicare amount, or 100 percent in certain cases. It also says the Medicare deductible would not apply to these tests.
No publicly available information.
No publicly available information.