Reducing Hereditary Cancer Act of 2025
Sponsored By: Senator Lisa Murkowski
Introduced
Summary
Expands Medicare coverage for hereditary cancer germline mutation testing. This bill would also require coverage of risk-reducing surgeries and more frequent cancer screenings for people at high inherited risk, all tied to evidence-based oncology guidelines.
Show full summary
- People on Medicare with a personal or family history of a hereditary cancer gene mutation or a history suspicious for hereditary cancer would be eligible for germline mutation testing that follows clinical practice guidelines. The bill would allow repeat testing when clinically appropriate.
- Individuals found to have a hereditary cancer germline mutation would have Medicare coverage for risk-reducing surgeries that guidelines say are likely to lower cancer risk, and screening frequency limits would be increased to match guideline recommendations, but not less often than annually. Screening examples listed include screening mammography, breast MRI, colonoscopy, and PSA testing.
- Coverage decisions would rely on evidence-based guidelines developed by nationally recognized oncology groups such as NCCN, ASCO, or SGO, and Medicare administrative contractors could determine which guideline to apply when multiple guidelines conflict.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Medicare coverage for genetic testing
If enacted, this bill would let Medicare cover germline mutation testing for people with a personal or family history of hereditary cancer. Tests must follow evidence-based clinical guidelines from recognized oncology groups. If guidelines conflict, Medicare contractors would use the least restrictive guideline. Medicare would cover repeat germline testing when allowed by those guidelines. Coverage would apply to tests furnished on or after the date of enactment.
Medicare coverage for risk-reducing surgery
If enacted, this bill would treat certain risk-reducing surgeries as reasonable and necessary and therefore cover them for people who meet guideline criteria and have a hereditary cancer mutation. The bill would also require the Secretary to increase how often Medicare covers evidence-based screenings for people with a detected hereditary mutation, and never less often than once a year. Examples listed include screening mammography, breast MRI, colonoscopy, and PSA testing. Coverage would apply to services furnished on or after the date of enactment.
Sponsors & CoSponsors
Sponsor
Lisa Murkowski
AK • R
Cosponsors
Elissa Slotkin
MI • D
Sponsored 9/10/2025
Roll Call Votes
No roll call votes available for this bill.
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