Finn Sawyer Access to Cancer Testing Act
This bill provides for coverage of certain cancer diagnostic and laboratory tests under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Specifically, the bill provides for coverage of microarray analysis, DNA and RNA sequencing, whole-exome sequencing, and other next-generation sequencing for individuals diagnosed with cancer.
Additionally, the Department of Health and Human Services must establish an education and awareness program for physicians and the public about genomic testing and the role of genetic counselors.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1780 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 1780
To facilitate the development of treatments for cancer, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 24, 2023
Mr. Bilirakis (for himself and Ms. Matsui) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committee on Ways and Means, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To facilitate the development of treatments for cancer, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Finn Sawyer Access to Cancer Testing
Act''.
SEC. 2. COVERAGE OF CANCER DIAGNOSTIC AND LABORATORY TESTS.
(a) Medicare.--
(1) Coverage.--Section 1861 of the Social Security Act (42
U.S.C. 1395x) is amended--
(A) in subsection (s)(2)--
(i) in subparagraph (JJ), by adding ``and''
at the end; and
(ii) by adding at the end the following new
subparagraph:
``(KK) cancer diagnostic and laboratory tests (as defined
in subsection (nnn)) furnished on or after the date that is 6
months after the date of the enactment of this subparagraph.'';
and
(B) by adding at the end the following new
subsection:
``(nnn) Cancer Diagnostic and Laboratory Tests.--
``(1) In general.--The term `cancer diagnostic and
laboratory tests' means--
``(A) microarray analysis, DNA sequencing, RNA
sequencing, whole-exome sequencing, and other forms of
next-generation sequencing furnished and reported by a
clinical laboratory (as defined in section 353(a) of
the Public Health Service Act); and
``(B) explanation and interpretation of any
analysis or sequencing described in subparagraph (A);
furnished to an individual diagnosed with cancer.
``(2) Frequency.--When an individual test as described in
paragraph (1) reports out the same genetic content, it may only
be furnished with respect to an individual diagnosed with a
cancer--
``(A) once upon the diagnosis of such cancer;
``(B) once upon any recurrence of such cancer; and
``(C) as necessary for purposes of planning
treatment or monitoring the progression of such cancer
or the response of such cancer to treatment.''.
(2) Payment.--Section 1833 of the Social Security Act (42
U.S.C. 1395l) is amended--
(A) in subsection (a)(1)--
(i) by striking ``and'' before ``(HH)'';
and
(ii) by inserting the following before the
semicolon: ``, and (II) with respect to cancer
diagnostic and laboratory tests (as defined in
section 1861(nnn)), the amount paid shall be an
amount equal to 80 percent (or 100 percent, in
the case of such tests for which payment is
made on an assignment-related basis) of the
lesser of the actual charge for the test or the
amount that would have been determined for such
test under section 1834A had such test been a
clinical diagnostic laboratory test;''; and
(B) in subsection (b)--
(i) by striking ``, and (13)'' and
inserting ``(13)''; and
(ii) by striking ``1861(n).'' and inserting
``section 1861(n), and (14) such deductible
shall not apply with respect to cancer
diagnostic and laboratory tests (as defined in
section 1861(nnn))''.
(3) Exclusion modification.--Section 1862(a)(1) of the
Social Security Act (42 U.S.C. 1395y(a)(1)) is amended--
(A) in subparagraph (O), by striking ``and'' at the
end;
(B) in subparagraph (P), by striking the semicolon
and inserting ``, and''; and
(C) by adding at the end the following new
subparagraph:
``(Q) in the case of cancer diagnostic and laboratory tests
(as defined in section 1861(nnn)), which are performed more
frequently than is covered under such section;''.
(b) Medicaid.--
(1) Inclusion as medical assistance.--Section 1905(a) of
the Social Security Act (42 U.S.C. 1396d(a)) is amended--
(A) in paragraph (30), by striking ``and'' at the
end;
(B) by redesignating paragraph (31) as paragraph
(32); and
(C) by inserting after paragraph (30) the following
new paragraph:
``(31) cancer diagnostic and laboratory tests (as defined
in section 1861(nnn)); and''.
(2) Mandatory coverage.--Section 1902(a)(10)(A) of such Act
is amended, in the matter preceding clause (i), by striking
``and (30)'' and inserting ``(30), and (31)''.
(3) Inclusion in benchmark coverage.--Section 1937(b)(5) of
such Act is amended by inserting before the period at the end
the following: ``, and beginning January 1, 2025, coverage of
cancer diagnostic and laboratory tests (as defined in section
1861(nnn))''.
(4) Conforming amendments.--Title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) is amended--
(A) in section 1902(nn)(3), by striking ``paragraph
(31) of section 1905(a)'' and inserting ``paragraph
(32) of section 1905(a)''; and
(B) in section 1905(a), in the 4th sentence in the
flush matter following the last numbered paragraph of
the first sentence of such section, by striking
``paragraph (30)'' and inserting ``paragraph (32)''.
(5) Effective date.--
(A) In general.--The amendments made by this
section shall apply with respect to items and services
furnished on or after January 1, 2025.
(B) Exemption for state legislation.--In the case
of a State plan under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.), or waiver of such plan,
that the Secretary of Health and Human Services
determines requires State legislation in order for the
respective plan to meet any requirement imposed by
amendments made by this section, the respective plan
shall not be regarded as failing to comply with the
requirements of such title solely on the basis of its
failure to meet such an additional requirement before
the first day of the first calendar quarter beginning
after the close of the first regular session of the
State legislature that begins after the date of the
enactment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year
legislative session, each year of the session shall be
considered to be a separate regular session of the
State legislature.
(c) CHIP.--Section 2103(c) of the Social Security Act (42 U.S.C.
1397cc(c)), as amended by section 11405(b)(1) of Public Law 117-169, is
amended by adding at the end the following new paragraph:
``(13) Coverage of cancer diagnostic and laboratory
tests.--Regardless of the type of coverage elected by a State
under subsection (a), beginning January 1, 2025, child health
assistance provided under such coverage for targeted low-income
children and, in the case that the State elects to provide
pregnancy-related assistance under such coverage pursuant to
section 2112, such pregnancy-related assistance for targeted
low-income pregnant women (as defined in section 2112(d)),
shall include coverage of cancer diagnostic and laboratory
tests (as defined in section 1861(nnn)).''.
SEC. 3. EDUCATION AND AWARENESS PROGRAM ON GENOMIC TESTING.
(a) In General.--The Secretary of Health and Human Services, in
coordination with the Director of the National Human Genome Research
Institute, shall carry out an education and awareness program for
physicians and the general public on what genomic testing is, how can
be used, and the role of genetic counselors.
(b) Cancer and Molecular Diagnostics.--The education and awareness
program under subsection (a) shall encourage the inclusion in graduate
medical education and continuing medical education (including for
specialty oncology services) of education and training on the
importance of molecular diagnostics at diagnosis and reoccurrence of
cancer to detect mutations.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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