Expanding Seniors’ Access to PFAS Testing Act
Summary
What This Bill Does
The Expanding Seniors' Access to PFAS Testing Act adds PFAS blood testing to Medicare preventive-service coverage. It defines PFAS testing as a blood test ordered by a physician to determine the concentration of perfluoroalkyl and polyfluoroalkyl substances. Beginning January 1, 2028, Medicare payment would cover PFAS testing at 100 percent of the lesser of the actual charges for testing or the amount determined under the applicable screening and preventive services fee schedule. The bill therefore removes beneficiary cost sharing for covered physician-ordered PFAS blood tests and adds the test to the Social Security Act preventive-service structure.
Who Benefits and How
Medicare beneficiaries with PFAS exposure concerns benefit because physician-ordered PFAS blood tests would be covered without cost sharing. Seniors in contaminated communities benefit from lower out-of-pocket costs for measuring PFAS blood concentrations. Physicians ordering PFAS tests benefit because Medicare coverage gives them a clearer pathway for testing exposed patients. Clinical laboratories offering PFAS blood tests benefit from a defined Medicare payment pathway starting in 2028.
Who Bears the Burden and How
CMS payment systems staff must add PFAS testing to preventive-service payment rules and apply the 100 percent payment formula. Federal taxpayers bear Medicare spending for newly covered PFAS blood testing. Medicare Administrative Contractors must process PFAS testing claims under the preventive-services fee schedule. Clinical laboratories must bill within the lesser-of-actual-charges-or-fee-schedule payment limit.
Key Provisions
- Adds PFAS testing to Medicare preventive-service coverage.
- Defines PFAS testing as a physician-ordered blood test for perfluoroalkyl and polyfluoroalkyl substances.
- Provides no-cost Medicare coverage for PFAS testing furnished on or after January 1, 2028.
- Requires payment at 100 percent of the lesser of actual charges or the preventive-services fee schedule amount.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Adds Medicare no-cost coverage for physician-ordered PFAS blood testing beginning January 1, 2028, paying 100 percent of the lesser of actual charges or the applicable preventive-services fee schedule amount.
Key Policy Areas
Medicare, Public Health, PFAS
Primary Purpose
Adds Medicare no-cost coverage for physician-ordered PFAS blood testing beginning January 1, 2028, paying 100 percent of the lesser of actual charges or the applicable preventive-services fee schedule amount.
Policy Domains
Resolution provisions
Identified Gains
- Medicare beneficiaries with PFAS exposure concerns
- Seniors in contaminated communities
- Physicians ordering PFAS tests
- Clinical laboratories offering PFAS blood tests
Identified Costs
- CMS payment systems staff
- Federal taxpayers
- Medicare Administrative Contractors
- Clinical laboratories
Sponsors
Legislative Progress
In CommitteeMrs. Dingell (for herself and Mr. Fitzpatrick) introduced the following …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Medicare Administrative Contractors, Medicare beneficiaries with PFAS exposure concerns
Positive-direction: Medicare beneficiaries with PFAS exposure concerns
Negative-direction: Medicare Administrative Contractors
Clinical laboratories offering PFAS blood tests
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology