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HR 842119th CongressIn Committee
Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act
Introduced: Jan 31, 2025
Sponsor: Rep. Arrington, Jodey C. [R-TX-19] (R-Texas)
HealthcareSocial Services
Standard Summary
Comprehensive overview in 1-2 paragraphs
The Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act would establish Medicare coverage for multi-cancer early detection (MCED) screening tests beginning January 1, 2028. These tests use blood samples to screen for multiple types of cancer simultaneously across different organ sites. The bill requires that covered tests be FDA-cleared or approved and deemed reasonable and necessary by the Secretary of Health and Human Services. The legislation aims to improve early cancer detection for Medicare beneficiaries through innovative screening technology that can identify multiple cancers with a single test, potentially leading to earlier treatment and better health outcomes.
Key Points
- 1Coverage begins January 1, 2028 for FDA-cleared or approved multi-cancer early detection screening tests that analyze cell-free nucleic acids in blood or blood products
- 2Payment structure sets the initial payment rate equal to existing multi-target stool DNA screening tests through 2030, with potential adjustments beginning in 2031
- 3Age-based eligibility starts at age 68 in 2028 and increases by one year annually, with tests limited to once per year (no more frequently than every 11 months)
- 4National coverage determination process required for the Secretary to evaluate whether tests are reasonable, necessary, and appropriate for Medicare beneficiaries
- 5Automatic adjustment provision eliminates payment and age restrictions if the U.S. Preventive Services Task Force gives the tests an A or B recommendation grade
Impact Areas
Medicare beneficiaries aged 68 and older who would gain access to innovative multi-cancer screening technologyHealthcare costs and Medicare spending through new screening coverage, though potentially offset by earlier cancer detection and treatmentCancer screening practices by supplementing rather than replacing existing single-cancer screening tests for breast, cervical, colorectal, lung, and prostate cancersMedical device and diagnostic companies developing multi-cancer early detection technologies seeking Medicare reimbursement
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