Finn Sawyer Access to Cancer Testing Act
Sponsored By: Senator Roger Wicker
Introduced
Summary
This bill would expand access to cancer genomic testing by making sequencing‑based diagnostic tests covered under Medicare, Medicaid, and CHIP, and would create a national education program about genomic testing and genetic counseling.
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- Medicare beneficiaries would be able to get microarray analysis, DNA and RNA sequencing, whole‑exome sequencing, and other next‑generation sequencing for cancer at diagnosis, recurrence, or to plan and monitor treatment. Coverage would begin six months after enactment and payment rules generally set Medicare at 80% of a specified amount, or 100% when paid on an assignment basis.
- Medicaid enrollees would see these cancer diagnostic tests added to medical assistance and to benchmark coverage, with an effective date of January 1, 2027 and allowances for state plan changes if state law is needed.
- Children and pregnant people covered by the Children’s Health Insurance Program would get the tests starting January 1, 2025 for targeted low‑income children and, where applicable, pregnancy‑related assistance.
- Clinicians and the public would gain a nationwide education and awareness program run by the Department of Health and Human Services with the National Human Genome Research Institute to boost training on molecular diagnostics in graduate medical education and continuing medical education, including oncology specialties.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 4 benefits, 0 costs, 0 mixed.
Medicaid must cover genomic cancer tests
If enacted, Medicaid would be required to cover genomic cancer tests for items and services furnished on or after January 1, 2027. State benchmark plans must include these tests starting January 1, 2027. States that need new state laws to change their plans get extra time until the first day of the first calendar quarter after their next regular legislative session ends. For States with two-year sessions, each year of the session counts separately for that delay.
Medicare covers genomic cancer tests
If enacted, Medicare Part B would cover certain genomic cancer tests starting six months after enactment. Medicare would pay 80% of the lesser of the lab charge or the hypothetical clinical-test amount, or 100% when payment is assignment-related. The Part B deductible would not apply to these tests. Tests reporting the same genetic content could be done once at diagnosis, once at any recurrence, and as needed for treatment planning or monitoring.
CHIP would cover cancer tests
If enacted, starting January 1, 2025, CHIP would cover cancer diagnostic and lab tests for targeted low-income children. If a State provides pregnancy-related CHIP help, targeted low-income pregnant women would also get this coverage. This applies no matter which type of CHIP coverage a State chooses.
National genomic testing education program
If enacted, HHS would run a nationwide program, with the National Human Genome Research Institute, to teach doctors and the public about genomic testing and the role of genetic counselors. The program would promote adding molecular diagnostics training to graduate medical education and continuing medical education, including for oncology specialists.
Sponsors & CoSponsors
Sponsor
Roger Wicker
MS • R
Cosponsors
Amy Klobuchar
MN • D
Sponsored 2/26/2025
Roll Call Votes
No roll call votes available for this bill.
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