Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act
Sponsored By: Senator Mike Crapo
Introduced
Summary
Medicare coverage for multi-cancer early detection screening tests. This bill would let the Secretary of Health and Human Services set who is eligible, define which tests qualify, and set payment amounts and standards while limiting tests by age and frequency.
Show full summary
- Older Medicare beneficiaries: People would be eligible starting at age 68 in 2028, with the age limit rising by one year each year. Each person could get one test every 11 months.
- Patients and clinicians: Covered tests must be FDA-cleared, classified, or approved and must be genomic blood tests that analyze cell-free nucleic acids or provide comparable results. The Secretary must determine a test is reasonable and necessary before Medicare pays.
- Medicare program and providers: Coverage decisions would use the national coverage determination process and follow a defined, phased payment schedule. The bill also includes an exception tied to U.S. Preventive Services Task Force recommendations when they endorse broader preventive screening.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 0 benefits, 0 costs, 3 mixed.
Medicare age and frequency limits
This bill would limit Medicare payment for a multi-cancer screening test if, on January 1 of the year, the person has reached the specified age (68 in 2028, and the age goes up by one year each later year). It would also bar payment if the person had a qualifying test in the prior 11 months. If the U.S. Preventive Services Task Force gives a test a grade A or B and coverage starts under the preventive coverage rule, those age and 11-month limits would not apply for that test.
Medicare payment rules for tests
This bill would set how Medicare pays for multi-cancer screening tests. Tests given before January 1, 2031 would be paid at the same dollar amount that applied on the date of enactment for a specific multi-target stool DNA test. For tests on or after January 1, 2031, payment would be the lower of that older amount or the amount computed under the Medicare payment rule in section 1834A. The bill would also make conforming cross-reference changes to Medicare payment law when enacted.
New Medicare multi-cancer coverage
This bill would create a new Medicare coverage category for multi-cancer early detection screening tests starting January 1, 2028. Tests would have to meet certain FDA clearance or approval rules and be genomic blood-based tests (or comparable samples) and be judged reasonable and necessary by the Medicare Secretary. The Secretary would use the Medicare national coverage determination process to decide coverage for new tests. The bill would also say Medicare would not pay for tests the Secretary finds are not reasonable and necessary, and it would not change coverage for other cancer screening tests or using these tests as diagnostic or confirmatory tests. These clarifications would take effect when the bill is enacted.
Sponsors & CoSponsors
Sponsor
Mike Crapo
ID • R
Cosponsors
Maggie Hassan
NH • D
Sponsored 6/24/2025
Michael Bennet
CO • D
Sponsored 1/30/2025
Tim Scott
SC • R
Sponsored 1/30/2025
Ron Wyden
OR • D
Sponsored 1/30/2025
James Lankford
OK • R
Sponsored 2/4/2025
Mike Rounds
SD • R
Sponsored 2/4/2025
Thomas Tillis
NC • R
Sponsored 2/5/2025
Ted Budd
NC • R
Sponsored 2/5/2025
Amy Klobuchar
MN • D
Sponsored 2/10/2025
Roger Marshall
KS • R
Sponsored 2/11/2025
Jon Ossoff
GA • D
Sponsored 2/18/2025
James Risch
ID • R
Sponsored 2/20/2025
Jeff Merkley
OR • D
Sponsored 2/24/2025
John Barrasso
WY • R
Sponsored 2/25/2025
Mark Kelly
AZ • D
Sponsored 3/4/2025
Shelley Capito
WV • R
Sponsored 3/4/2025
Jacky Rosen
NV • D
Sponsored 3/6/2025
Christopher Coons
DE • D
Sponsored 3/10/2025
John Fetterman
PA • D
Sponsored 3/10/2025
Richard Blumenthal
CT • D
Sponsored 3/11/2025
John Reed
RI • D
Sponsored 3/11/2025
John Hickenlooper
CO • D
Sponsored 3/11/2025
Jeanne Shaheen
NH • D
Sponsored 3/12/2025
Sheldon Whitehouse
RI • D
Sponsored 3/12/2025
Chuck Grassley
IA • R
Sponsored 3/13/2025
Maria Cantwell
WA • D
Sponsored 3/13/2025
Kevin Cramer
ND • R
Sponsored 3/13/2025
John Boozman
AR • R
Sponsored 3/14/2025
Ruben Gallego
AZ • D
Sponsored 3/14/2025
Lindsey Graham
SC • R
Sponsored 3/24/2025
Bill Cassidy
LA • R
Sponsored 3/24/2025
Markwayne Mullin
OK • R
Sponsored 3/24/2025
Susan Collins
ME • R
Sponsored 3/25/2025
Kirsten Gillibrand
NY • D
Sponsored 3/26/2025
Rick Scott
FL • R
Sponsored 3/26/2025
Catherine Cortez Masto
NV • D
Sponsored 3/26/2025
Elissa Slotkin
MI • D
Sponsored 3/26/2025
Steve Daines
MT • R
Sponsored 3/31/2025
John Cornyn
TX • R
Sponsored 4/2/2025
James Justice
WV • R
Sponsored 4/3/2025
Bernie Moreno
OH • R
Sponsored 4/4/2025
Martin Heinrich
NM • D
Sponsored 4/7/2025
Sen. McConnell, Mitch [R-KY]
KY • R
Sponsored 4/9/2025
Mark Warner
VA • D
Sponsored 4/10/2025
Tammy Baldwin
WI • D
Sponsored 4/10/2025
Cory Booker
NJ • D
Sponsored 4/28/2025
Patty Murray
WA • D
Sponsored 4/28/2025
Cindy Hyde-Smith
MS • R
Sponsored 5/5/2025
Angus King
ME • I
Sponsored 5/20/2025
Peter Welch
VT • D
Sponsored 6/3/2025
Alex Padilla
CA • D
Sponsored 6/3/2025
Jim Banks
IN • R
Sponsored 6/11/2025
Jon Husted
OH • R
Sponsored 7/9/2025
Angela Alsobrooks
MD • D
Sponsored 7/9/2025
Todd Young
IN • R
Sponsored 7/14/2025
John Kennedy
LA • R
Sponsored 7/29/2025
Tina Smith
MN • D
Sponsored 7/31/2025
Gary Peters
MI • D
Sponsored 9/2/2025
Lisa Blunt Rochester
DE • D
Sponsored 9/2/2025
Adam Schiff
CA • D
Sponsored 9/4/2025
Andy Kim
NJ • D
Sponsored 9/8/2025
Lisa Murkowski
AK • R
Sponsored 10/8/2025
Chris Van Hollen
MD • D
Sponsored 10/14/2025
Katie Britt
AL • R
Sponsored 10/15/2025
Roger Wicker
MS • R
Sponsored 10/21/2025
Dan Sullivan
AK • R
Sponsored 10/23/2025
Mazie Hirono
HI • D
Sponsored 12/15/2025
David McCormick
PA • R
Sponsored 3/2/2026
Roll Call Votes
No roll call votes available for this bill.
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