Lung Cancer Screening Expansion Act of 2025
Summary
What This Bill Does
The Lung Cancer Screening Expansion Act requires group health plans, group and individual health insurance issuers, and applicable Federal health programs to provide full coverage without cost-sharing for annual low-dose computed tomography or other appropriate lung cancer screening technologies. Eligible individuals are adults ages 50 to 80 who a treating health care professional determines are at increased risk for lung cancer based on personal, environmental, or familial risk factors. Coverage cannot be subject to prior authorization, step therapy or other utilization controls, frequency limits more restrictive than one screening per year, or documentation beyond recent evidence-based clinical guidelines. HHS, Defense, VA, and OPM must issue implementing regulations within 180 days and ensure program-wide compliance.
Who Benefits and How
Adults ages 50 to 80 at increased lung cancer risk benefit from annual screening without out-of-pocket cost-sharing or common utilization barriers. Pulmonologists, radiology providers, cancer centers, and screening programs benefit from broader covered demand for LDCT and other appropriate technologies. Federal employees, veterans, military beneficiaries, and privately insured patients all receive coverage through the bill’s broad payer scope.
Who Bears the Burden and How
Health insurers, group health plans, Federal health programs, and employer plans must cover annual screening and remove prior authorization, step therapy, restrictive frequency limits, and extra documentation. HHS, Defense, VA, and OPM must issue regulations within 180 days and monitor compliance. Payers may face higher screening costs.
Key Provisions
- Requires full coverage without cost-sharing for annual LDCT or other appropriate lung cancer screening technologies.
- Expands eligibility to adults ages 50 to 80 determined by treating professionals to have increased risk from personal, environmental, or familial factors.
- Prohibits prior authorization, step therapy, restrictive annual frequency limits, and extra documentation beyond evidence-based guidelines.
- Directs HHS, Defense, VA, and OPM to issue implementing regulations within 180 days.
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
Requires health insurers and Federal health programs to cover annual lung cancer screening without cost-sharing, prior authorization, step therapy, restrictive frequency limits, or extra documentation for eligible adults ages 50 to 80.
Key Policy Areas
Healthcare, Insurance, Cancer Screening
Primary Purpose
Requires health insurers and Federal health programs to cover annual lung cancer screening without cost-sharing, prior authorization, step therapy, restrictive frequency limits, or extra documentation for eligible adults ages 50 to 80.
Policy Domains
Substantive provisions
Identified Gains
- Adults ages 50 to 80 at increased lung cancer risk
- Radiology providers
- Cancer screening programs
- Veterans needing lung cancer screening
Identified Costs
- Health insurance issuers
- Group health plans
- Department of Health and Human Services
- Department of Veterans Affairs
- Department of Defense
- Office of Personnel Management
Legislative Progress
In CommitteeReferred to the Subcommittee on Health.
Mr. Torres of New York introduced the following bill; which …
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.
Adults ages 50 to 80 at increased lung cancer risk, Radiology providers
Group health plans, Health insurance issuers
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