S339119th CongressWALLET

Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act

Sponsored By: Senator Crapo, Mike [R-ID]

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

Crapo, Mike [R-ID]

ID • R

Cosponsors

  • Sen. Hassan, Margaret Wood [D-NH]

    NH • D

    Sponsored 6/24/2025

  • Sen. Bennet, Michael F. [D-CO]

    CO • D

    Sponsored 1/30/2025

  • Sen. Scott, Tim [R-SC]

    SC • R

    Sponsored 1/30/2025

  • Sen. Wyden, Ron [D-OR]

    OR • D

    Sponsored 1/30/2025

  • Sen. Lankford, James [R-OK]

    OK • R

    Sponsored 2/4/2025

  • Mike Rounds

    SD • R

    Sponsored 2/4/2025

  • Sen. Tillis, Thomas [R-NC]

    NC • R

    Sponsored 2/5/2025

  • Sen. Budd, Ted [R-NC]

    NC • R

    Sponsored 2/5/2025

  • Amy Klobuchar

    MN • D

    Sponsored 2/10/2025

  • Sen. Marshall, Roger [R-KS]

    KS • R

    Sponsored 2/11/2025

  • Sen. Ossoff, Jon [D-GA]

    GA • D

    Sponsored 2/18/2025

  • Sen. Risch, James E. [R-ID]

    ID • R

    Sponsored 2/20/2025

  • Sen. Merkley, Jeff [D-OR]

    OR • D

    Sponsored 2/24/2025

  • Sen. Barrasso, John [R-WY]

    WY • R

    Sponsored 2/25/2025

  • Sen. Kelly, Mark [D-AZ]

    AZ • D

    Sponsored 3/4/2025

  • Shelley Capito

    WV • R

    Sponsored 3/4/2025

  • Sen. Rosen, Jacky [D-NV]

    NV • D

    Sponsored 3/6/2025

  • Sen. Coons, Christopher A. [D-DE]

    DE • D

    Sponsored 3/10/2025

  • Sen. Fetterman, John [D-PA]

    PA • D

    Sponsored 3/10/2025

  • Sen. Blumenthal, Richard [D-CT]

    CT • D

    Sponsored 3/11/2025

  • Sen. Reed, Jack [D-RI]

    RI • D

    Sponsored 3/11/2025

  • John Hickenlooper

    CO • D

    Sponsored 3/11/2025

  • Sen. Shaheen, Jeanne [D-NH]

    NH • D

    Sponsored 3/12/2025

  • Sen. Whitehouse, Sheldon [D-RI]

    RI • D

    Sponsored 3/12/2025

  • Sen. Grassley, Chuck [R-IA]

    IA • R

    Sponsored 3/13/2025

  • Sen. Cantwell, Maria [D-WA]

    WA • D

    Sponsored 3/13/2025

  • Sen. Cramer, Kevin [R-ND]

    ND • R

    Sponsored 3/13/2025

  • John Boozman

    AR • R

    Sponsored 3/14/2025

  • Sen. Gallego, Ruben [D-AZ]

    AZ • D

    Sponsored 3/14/2025

  • Sen. Graham, Lindsey [R-SC]

    SC • R

    Sponsored 3/24/2025

  • Sen. Cassidy, Bill [R-LA]

    LA • R

    Sponsored 3/24/2025

  • Markwayne Mullin

    OK • R

    Sponsored 3/24/2025

  • Sen. Collins, Susan M. [R-ME]

    ME • R

    Sponsored 3/25/2025

  • Sen. Gillibrand, Kirsten E. [D-NY]

    NY • D

    Sponsored 3/26/2025

  • Sen. Scott, Rick [R-FL]

    FL • R

    Sponsored 3/26/2025

  • Sen. Cortez Masto, Catherine [D-NV]

    NV • D

    Sponsored 3/26/2025

  • Elissa Slotkin

    MI • D

    Sponsored 3/26/2025

  • Sen. Daines, Steve [R-MT]

    MT • R

    Sponsored 3/31/2025

  • Sen. Cornyn, John [R-TX]

    TX • R

    Sponsored 4/2/2025

  • Sen. Justice, James C. [R-WV]

    WV • R

    Sponsored 4/3/2025

  • Sen. Moreno, Bernie [R-OH]

    OH • R

    Sponsored 4/4/2025

  • Sen. Heinrich, Martin [D-NM]

    NM • D

    Sponsored 4/7/2025

  • Sen. McConnell, Mitch [R-KY]

    KY • R

    Sponsored 4/9/2025

  • Sen. Warner, Mark R. [D-VA]

    VA • D

    Sponsored 4/10/2025

  • Sen. Baldwin, Tammy [D-WI]

    WI • D

    Sponsored 4/10/2025

  • Sen. Booker, Cory A. [D-NJ]

    NJ • D

    Sponsored 4/28/2025

  • Sen. Murray, Patty [D-WA]

    WA • D

    Sponsored 4/28/2025

  • Cindy Hyde-Smith

    MS • R

    Sponsored 5/5/2025

  • Sen. King, Angus S., Jr. [I-ME]

    ME • I

    Sponsored 5/20/2025

  • Peter Welch

    VT • D

    Sponsored 6/3/2025

  • Sen. Padilla, Alex [D-CA]

    CA • D

    Sponsored 6/3/2025

  • Sen. Banks, Jim [R-IN]

    IN • R

    Sponsored 6/11/2025

  • Sen. Husted, Jon [R-OH]

    OH • R

    Sponsored 7/9/2025

  • Sen. Alsobrooks, Angela D. [D-MD]

    MD • D

    Sponsored 7/9/2025

  • Sen. Young, Todd [R-IN]

    IN • R

    Sponsored 7/14/2025

  • Sen. Kennedy, John [R-LA]

    LA • R

    Sponsored 7/29/2025

  • Sen. Smith, Tina [D-MN]

    MN • D

    Sponsored 7/31/2025

  • Gary Peters

    MI • D

    Sponsored 9/2/2025

  • Sen. Blunt Rochester, Lisa [D-DE]

    DE • D

    Sponsored 9/2/2025

  • Sen. Schiff, Adam B. [D-CA]

    CA • D

    Sponsored 9/4/2025

  • Sen. Kim, Andy [D-NJ]

    NJ • D

    Sponsored 9/8/2025

  • Sen. Murkowski, Lisa [R-AK]

    AK • R

    Sponsored 10/8/2025

  • Sen. Van Hollen, Chris [D-MD]

    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

  • Sen. Hirono, Mazie K. [D-HI]

    HI • D

    Sponsored 12/15/2025

  • Sen. McCormick, David [R-PA]

    PA • R

    Sponsored 3/2/2026

Roll Call Votes

No roll call votes available for this bill.

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