Senate Bill Proposes to Expand Medicare Coverage for Hereditary Cancer Testing

A new bill in front of the US Congress proposes an expansion of Medicare coverage for genomic testing and certain follow-up services in individuals with a family history of hereditary cancer.

If passed, the bill would amend title XVIII of the Social Security Act such that it mandates Medicare coverage for germline mutation testing in individuals with a known, hereditary cancer gene mutation in their family or a history otherwise suspicious for hereditary cancer. This would be limited to once per individual.

For patients who are found to have a hereditary cancer mutation, coverage would also be guaranteed for risk-reducing surgeries as endorsed by evidence-based guidelines.

For mutation-positive persons who do not to undergo preventive surgery, the bill also mandates reimbursement for preventative screening at an increased frequency – “in compliance with National Comprehensive Cancer Network guidelines or as determined by the Secretary, but no less frequently than on an annual basis.”

Source: https://www.genomeweb.com/cancer/senate-bill-proposes-expand-medicare-coverage-hereditary-cancer-testing