Improving Medicaid Precision and Cancer Test Act of 2025
Summary
What This Bill Does
The Improving Medicaid Precision and Cancer Test Act amends Medicaid to add lung cancer biomarker testing as a covered medical assistance category. It also requires benchmark and benchmark-equivalent Medicaid coverage to include lung cancer biomarker testing beginning January 1, 2027. The bill makes conforming amendments to Social Security Act sections 1902, 1905, and 1937.
Who Benefits and How
Medicaid beneficiaries diagnosed with lung cancer benefit from coverage of biomarker testing that can identify genes, proteins, or other markers relevant to targeted treatment. Oncology practices, laboratories, and cancer centers benefit from Medicaid reimbursement for testing. State Medicaid programs gain clear Federal coverage direction.
Who Bears the Burden and How
State Medicaid agencies and managed care plans must cover lung cancer biomarker testing beginning in 2027 and update benefit systems. Federal and State Medicaid budgets may bear new testing costs. CMS must oversee State compliance and conforming coverage rules.
Key Provisions
- Adds lung cancer biomarker testing to Medicaid covered medical assistance.
- Requires benchmark Medicaid coverage to include lung cancer biomarker testing beginning January 1, 2027.
- Amends Social Security Act sections 1902, 1905, and 1937 to implement the new coverage category.
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 Medicaid coverage of lung cancer biomarker testing beginning January 1, 2027.
Key Policy Areas
Healthcare, Medicaid, Cancer Testing
Primary Purpose
Requires Medicaid coverage of lung cancer biomarker testing beginning January 1, 2027.
Policy Domains
Substantive provisions
Identified Gains
- Medicaid beneficiaries with lung cancer
- Oncology laboratories
- Cancer treatment centers
- State Medicaid programs
Identified Costs
- State Medicaid agencies
- Centers for Medicare and Medicaid Services
- Medicaid managed care plans
- Federal and State Medicaid budgets
Sponsors
Legislative Progress
In CommitteeMr. Gottheimer (for himself and Mr. Rutherford) introduced the following …
Referred to the House Committee on Energy and Commerce.
Introduced in House
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