Us Congress 2025-2026 Regular Session

Us Congress House Bill HB842 Compare Versions

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Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 842
5	5	To amend title XVIII of the Social Security Act to provide for Medicare
6	6	coverage of multi-cancer early detection screening tests.
7	7	IN THE HOUSE OF REPRESENTATIVES
8	8	JANUARY31, 2025
9	9	Mr. A
10	10	RRINGTON(for himself, Ms. SEWELL, Mr. HUDSON, Mr. RUIZ, Mrs.
11	11	M
12	12	ILLER-MEEKS, and Ms. KELLYof Illinois) introduced the following bill;
13	13	which was referred to the Committee on Energy and Commerce, and in
14	14	addition to the Committee on Ways and Means, for a period to be subse-
15	15	quently determined by the Speaker, in each case for consideration of such
16	16	provisions as fall within the jurisdiction of the committee concerned
17	17	A BILL
18	18	To amend title XVIII of the Social Security Act to provide
19	19	for Medicare coverage of multi-cancer early detection
20	20	screening tests.
21	21	Be it enacted by the Senate and House of Representa-1
22	22	tives of the United States of America in Congress assembled, 2
23	23	SECTION 1. SHORT TITLE. 3
24	24	This Act may be cited as the ‘‘Nancy Gardner Sewell 4
25	25	Medicare Multi-Cancer Early Detection Screening Cov-5
26	26	erage Act’’. 6
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29	29	•HR 842 IH
30	30	SEC. 2. MEDICARE COVERAGE OF MULTI-CANCER EARLY 1
31	31	DETECTION SCREENING TESTS. 2
32	32	(a) C
33	33	OVERAGE.—Section 1861 of the Social Security 3
34	34	Act (42 U.S.C. 1395x) is amended— 4
35	35	(1) in subsection (s)(2)— 5
36	36	(A) by striking the semicolon at the end of 6
37	37	subparagraph (JJ) and inserting ‘‘; and’’; and 7
38	38	(B) by adding at the end the following new 8
39	39	subparagraph: 9
40	40	‘‘(KK) multi-cancer early detection screen-10
41	41	ing tests (as defined in subsection (nnn));’’; and 11
42	42	(2) by adding at the end the following new sub-12
43	43	section: 13
44	44	‘‘(nnn) M
45	45	ULTI-CANCEREARLYDETECTIONSCREEN-14
46	46	INGTESTS.— 15
47	47	‘‘(1) I
48	48	N GENERAL.—The term ‘multi-cancer 16
49	49	early detection screening test’ means a test fur-17
50	50	nished to an individual for the concurrent detection 18
51	51	of multiple cancer types across multiple organ sites 19
52	52	on or after January 1, 2028, that— 20
53	53	‘‘(A) is cleared under section 510(k), clas-21
54	54	sified under section 513(f)(2), or approved 22
55	55	under section 515 of the Federal Food, Drug, 23
56	56	and Cosmetic Act; 24
57	57	‘‘(B) is— 25
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60	60	•HR 842 IH
61	61	‘‘(i) a genomic sequencing blood or 1
62	62	blood product test that includes the anal-2
63	63	ysis of cell-free nucleic acids; or 3
64	64	‘‘(ii) a test based on samples of bio-4
65	65	logical material that provides results com-5
66	66	parable to those obtained with a test de-6
67	67	scribed in clause (i), as determined by the 7
68	68	Secretary; and 8
69	69	‘‘(C) the Secretary determines is— 9
70	70	‘‘(i) reasonable and necessary for the 10
71	71	prevention or early detection of an illness 11
72	72	or disability; and 12
73	73	‘‘(ii) appropriate for individuals enti-13
74	74	tled to benefits under part A or enrolled 14
75	75	under part B. 15
76	76	‘‘(2) NCD
77	77	PROCESS.—In making determina-16
78	78	tions under paragraph (1)(C) regarding the coverage 17
79	79	of a new test, the Secretary shall use the process for 18
80	80	making national coverage determinations (as defined 19
81	81	in section 1869(f)(1)(B)) under this title.’’. 20
82	82	(b) P
83	83	AYMENT ANDSTANDARDS FOR MULTI-CANCER 21
84	84	E
85	85	ARLYDETECTIONSCREENINGTESTS.— 22
86	86	(1) I
87	87	N GENERAL.—Section 1834 of the Social 23
88	88	Security Act (42 U.S.C. 1395m) is amended by add-24
89	89	ing at the end the following new subsection: 25
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92	92	•HR 842 IH
93	93	‘‘(aa) PAYMENT AND STANDARDS FOR MULTI-CAN-1
94	94	CEREARLYDETECTIONSCREENINGTESTS.— 2
95	95	‘‘(1) P
96	96	AYMENT AMOUNT .—The payment 3
97	97	amount for a multi-cancer early detection screening 4
98	98	test (as defined in section 1861(nnn)) is— 5
99	99	‘‘(A) with respect to such a test furnished 6
100	100	before January 1, 2031, equal to the payment 7
101	101	amount in effect on the date of the enactment 8
102	102	of this subsection for a multi-target stool 9
103	103	screening DNA test covered pursuant to section 10
104	104	1861(pp)(1)(D); and 11
105	105	‘‘(B) with respect to such a test furnished 12
106	106	on or after January 1, 2031, equal to the lesser 13
107	107	of— 14
108	108	‘‘(i) the amount described in subpara-15
109	109	graph (A); or 16
110	110	‘‘(ii) the payment amount determined 17
111	111	for such test under section 1834A. 18
112	112	‘‘(2) L
113	113	IMITATIONS.— 19
114	114	‘‘(A) I
115	115	N GENERAL.—No payment may be 20
116	116	made under this part for a multi-cancer early 21
117	117	detection screening test furnished during a year 22
118	118	to an individual if— 23
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121	121	•HR 842 IH
122	122	‘‘(i) as of January 1 of such year, 1
123	123	such individual has attained the age speci-2
124	124	fied in subparagraph (B) for such year; or 3
125	125	‘‘(ii) such a test was furnished to the 4
126	126	individual during the previous 11 months. 5
127	127	‘‘(B) A
128	128	GE SPECIFIED.—For purposes of 6
129	129	subparagraph (A)(i), the age specified in this 7
130	130	subparagraph is— 8
131	131	‘‘(i) for 2028, 68 years of age; and 9
132	132	‘‘(ii) for a succeeding year, the age 10
133	133	specified in this subparagraph for the pre-11
134	134	ceding year, increased by 1 year. 12
135	135	‘‘(3) S
136	136	TANDARDS FOLLOWING USPSTF RAT -13
137	137	ING.—In the case of a multi-cancer early detection 14
138	138	screening test that is recommended with a grade of 15
139	139	A or B by the United States Preventive Services 16
140	140	Task Force, beginning on the date on which cov-17
141	141	erage for such test is provided pursuant to section 18
142	142	1861(ddd)(1), the preceding provisions of this sub-19
143	143	section shall not apply.’’. 20
144	144	(2) C
145	145	ONFORMING AMENDMENTS .— 21
146	146	(A) Section 1833 of the Social Security 22
147	147	Act (42 U.S.C. 1395l) is amended— 23
148	148	(i) in subsection (a)— 24
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151	151	•HR 842 IH
152	152	(I) in paragraph (1)(D)(i)(I), by 1
153	153	striking ‘‘section 1834(d)(1)’’ and in-2
154	154	serting ‘‘subsection (d)(1) or (aa) of 3
155	155	section 1834’’; and 4
156	156	(II) in paragraph (2)(D)(i)(I), by 5
157	157	striking ‘‘section 1834(d)(1)’’ and in-6
158	158	serting ‘‘subsection (d)(1) or (aa) of 7
159	159	section 1834’’; and 8
160	160	(ii) in subsection (h), by striking ‘‘sec-9
161	161	tion 1834(d)(1)’’ and inserting ‘‘sub-10
162	162	sections (d)(1) and (aa) of section 1834’’. 11
163	163	(B) Section 1862(a) of the Social Security 12
164	164	Act (42 U.S.C. 1395y(a)) is amended— 13
165	165	(i) in paragraph (1)— 14
166	166	(I) in subparagraph (O), by 15
167	167	striking ‘‘and’’ at the end; 16
168	168	(II) in subparagraph (P), by 17
169	169	striking the semicolon at the end and 18
170	170	inserting ‘‘, and’’; and 19
171	171	(III) by adding at the end the 20
172	172	following new subparagraph: 21
173	173	‘‘(Q) in the case of multi-cancer early de-22
174	174	tection screening tests (as defined in section 23
175	175	1861(nnn)), which are not reasonable and nec-24
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178	178	•HR 842 IH
179	179	essary for the concurrent detection of multiple 1
180	180	cancer types across multiple organ sites;’’; and 2
181	181	(ii) in paragraph (7), by striking ‘‘or 3
182	182	(P)’’ and inserting ‘‘(P), or (Q)’’. 4
183	183	(c) R
184	184	ULE OFCONSTRUCTIONRELATING TOOTHER 5
185	185	C
186	186	ANCERSCREENINGTESTS.—Nothing in this section, in-6
187	187	cluding the amendments made by this section, shall be 7
188	188	construed— 8
189	189	(1) in the case of an individual who undergoes 9
190	190	a multi-cancer early detection screening test, to af-10
191	191	fect coverage under part B of title XVIII of the So-11
192	192	cial Security Act for other cancer screening tests 12
193	193	covered under such title, such as screening tests for 13
194	194	breast, cervical, colorectal, lung, or prostate cancer; 14
195	195	or 15
196	196	(2) in the case of an individual who undergoes 16
197	197	another cancer screening test, to affect coverage 17
198	198	under such part for a multi-cancer early detection 18
199	199	screening test or the use of such a test as a diag-19
200	200	nostic or confirmatory test for a result of the other 20
201	201	cancer screening test. 21
202	202	Æ
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