H.R. 1620 — Finn Sawyer Access to Cancer Testing Act

This section establishes Medicare Part B coverage of cancer diagnostic and laboratory tests (i.e., microarray analysis, DNA/RNA/whole-exome/next-generation sequencing by clinical laboratories, and related explanation/interpretation, furnished to individuals diagnosed with cancer, subject to frequency limits of once upon diagnosis, once upon recurrence, and as necessary for treatment planning or monitoring) furnished on or after January 1, 2027; sets payment at 80 percent (or 100 percent on an assignment-related basis) of the lesser of the actual charge or the clinical laboratory fee schedule amount; excludes such tests from the Part B deductible; and limits coverage to tests not performed more frequently than allowed (thus treating excess tests as not reasonable and necessary). This section requires state Medicaid programs to cover such tests as of January 1, 2027 (including in benchmark plans), with a state legislation exemption allowing delayed implementation until the end of the first regular legislative session after enactment. This section requires state Children's Health Insurance Program (CHIP) plans to cover such tests for targeted low-income children (and pregnant women, if elected) as of January 1, 2027, regardless of benchmark or other elected coverage.

This section directs the Secretary of Health and Human Services, in coordination with the Director of the National Human Genome Research Institute, to carry out an education and awareness program for physicians and the general public on genomic testing, its uses, and the role of genetic counselors. The program must encourage inclusion of education and training on the importance of molecular diagnostics to detect cancer mutations at diagnosis and recurrence in graduate medical education and continuing medical education, including for specialty oncology services.