Lung Cancer Medicare Access to Precise Testing Act
Summary
What This Bill Does
The Lung Cancer Medicare Access to Precise Testing Act adds lung cancer biomarker testing to Medicare Part B for tests furnished on or after January 1, 2027, to individuals diagnosed with lung cancer. Covered tests identify one or more biomarkers, such as genes, proteins, or other molecules, through analysis of tissue, blood, or bodily fluids. Medicare payment is set at 100 percent of the reasonable charges for the testing.
Who Benefits and How
Medicare beneficiaries diagnosed with lung cancer benefit from coverage with no partial-payment formula for biomarker testing that can guide targeted therapy. Oncology laboratories, cancer centers, and precision medicine providers benefit from Medicare reimbursement. Clinicians benefit from more reliable access to biomarker results for treatment selection.
Who Bears the Burden and How
CMS must add the new benefit, define claims and coverage processes, and pay 100 percent of reasonable charges. Medicare spending may increase because covered testing becomes payable beginning in 2027. Laboratories must comply with Medicare billing and documentation rules.
Key Provisions
- Adds lung cancer biomarker testing to Medicare Part B beginning January 1, 2027.
- Defines covered tests as identifying biomarkers such as genes, proteins, or molecules from tissue, blood, or bodily fluids.
- Requires Medicare payment at 100 percent of reasonable charges for covered testing.
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 Medicare to cover lung cancer biomarker testing beginning January 1, 2027, and pay 100 percent of reasonable charges for covered testing.
Key Policy Areas
Healthcare, Medicare, Cancer Testing
Primary Purpose
Requires Medicare to cover lung cancer biomarker testing beginning January 1, 2027, and pay 100 percent of reasonable charges for covered testing.
Policy Domains
Substantive provisions
Identified Gains
- Medicare beneficiaries with lung cancer
- Oncology laboratories
- Cancer centers
- Precision medicine providers
Identified Costs
- Centers for Medicare and Medicaid Services
- Medicare program
- Clinical laboratories billing Medicare
Sponsors
Legislative Progress
In CommitteeMr. Gottheimer (for himself and Mrs. Kiggans of Virginia) introduced …
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 beneficiaries with lung cancer, Oncology laboratories
Centers for Medicare and Medicaid Services, Medicare program
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