PREFERRED Screening Act
Sponsored By: Senator Cassidy, Bill [R-LA]
Introduced
Summary
Personalized risk‑based breast cancer screening for Medicare beneficiaries would create a 7‑year demonstration to pay providers for comprehensive breast cancer risk assessments and tailored screening and risk‑reduction plans.
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- Medicare beneficiaries age 40–74 enrolled in Part A or Part B but not Medicare Advantage would be eligible for assessments that combine multigene panel results, polygenic risk scores, breast density, family history, and clinical and lifestyle factors to assign risk categories and produce a personalized screening and risk‑reduction plan.
- Eligible providers such as physicians, nurse practitioners, physician assistants, certified nurse‑midwives, and genetic counselors would be reimbursed for assessment and plan development with payments informed by clinical time, complexity, genetic interpretation, and alignment with the physician fee schedule. Laboratories that submit de‑identified genomic variant data to ClinVar get selection priority.
- The Model would begin on the date the first eligible person receives an assessment, must start within 2 years or trigger notification of delay, and run for 7 years. The Secretary would evaluate access, screening patterns by risk, MRI and endocrine therapy use, 10‑ and 20‑year cost‑effectiveness, and cancer stage at detection to inform adjustments and possible expansion to Medicare Advantage.
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Bill Overview
Analyzed Economic Effects
8 provisions identified: 6 benefits, 0 costs, 2 mixed.
Evaluation, reports, and expansion review
If enacted, CMS would evaluate the Model using many measures like assessment uptake, whether planned services were furnished, MRI use for high-risk people, use of endocrine prevention medicines, and cost-effectiveness over 10 and 20 years. CMS must give an interim report within 3 years of Model start and a final report within 7 years. The reports must include the rate of labs submitting data to ClinVar and recommendations on expanding or making the Model permanent, including possible expansion to Medicare Advantage.
Personalized screening and plans
If enacted, the Model would require personalized screening and risk-reduction plans based on risk level. Plans would recommend screening frequency and imaging types, refer high-risk people for breast MRI, offer counseling on modifiable risks and on endocrine prevention medicines, refer for genetic counseling when needed, set reassessment timing, notify first-degree relatives when relevant, and send the plan to the person’s primary care record.
What a risk check must include
If enacted, assessments under the Model would have to collect genetic panel results (including BRCA1, BRCA2, PALB2, CDH1, TP53, PTEN, STK11, ATM, CHEK2 and others CMS picks), polygenic risk scores, family history, breast density, clinical and lifestyle risk factors, and other relevant items. CMS would require use of a validated model to estimate 5-year breast cancer risk and place people into at least “high-risk” and “elevated-risk” groups.
Who can deliver assessments locally
If enacted, many clinicians would be eligible to get paid for providing assessments and plans. That would include doctors, nurse practitioners, physician assistants, certified genetic counselors, midwives, and others CMS approves. The Model would let providers deliver services in person or remotely, including home genetic test kits. CMS would prioritize enrolling academic, community, and rural providers, and give priority to sites in the 10 States with the highest female breast cancer deaths and to shortage or medically underserved areas.
New Medicare breast-risk model
If enacted, the bill would create a time-limited Medicare payment model to pay providers for comprehensive breast cancer risk assessments and personalized screening plans. The Secretary must start the Model within 2 years of enactment and the Model would end 7 years after it begins. No new appropriations would be authorized; CMS must run the Model using funds it already has under the named authority.
Who is eligible for checks
If enacted, the Model would apply only to people on Medicare Part A or Part B who are not in Medicare Advantage (Part C). You would need to be age 40 through 74 and not receiving hospice or dialysis for end-stage renal disease. The Model would start when the first eligible person gets a covered comprehensive risk assessment.
Labs must share genetic variants
If enacted, CMS could favor providers who use labs that submit de-identified variant data, including variants of uncertain significance, to the ClinVar public database. The Model’s interim and final reports must show the rate of labs used by providers that submit such variant data to ClinVar.
Payments for assessments and plans
If enacted, the Secretary would set a payment amount to reimburse clinicians for providing the full risk assessment and personalized plan. CMS must consider clinical time, complexity, interpretation of genetic and polygenic results and breast density, and time to develop plans. CMS could adjust the payment during the Model based on evaluation results and whether payments sustain provider participation.
Sponsors & CoSponsors
Sponsor
Cassidy, Bill [R-LA]
LA • R
Cosponsors
Sen. Murkowski, Lisa [R-AK]
AK • R
Sponsored 8/5/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov