S. 755 — Finn Sawyer Access to Cancer Testing Act

This section establishes Medicare Part B coverage of cancer diagnostic and laboratory tests (defined in new SSA §1861(nnn) as next-generation sequencing analyses, including DNA/RNA sequencing and microarray furnished by clinical laboratories to individuals diagnosed with cancer, plus related explanations/interpretations, subject to frequency limits of once upon diagnosis, once upon recurrence, and as necessary for treatment planning, progression monitoring, or treatment response) furnished on or after January 1, 2027. It sets payment at 80 percent (or 100 percent on an assignment-related basis) of the lesser of the actual charge or the amount determined under the clinical laboratory fee schedule (SSA §1834A); excludes such tests from the Part B deductible; and deems noncovered any tests furnished more frequently than allowed. This section requires Medicaid coverage of such tests as a mandatory benefit under SSA §1902(a)(10)(A), includes them in the definition of medical assistance under SSA §1905(a), and requires their inclusion in benchmark coverage plans beginning January 1, 2027 (with an exemption for states requiring legislation). This section requires CHIP coverage of such tests for targeted low-income children and (if elected) pregnant women beginning January 1, 2025, regardless of benchmark plan elected.

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 what genomic testing is, how it can be used, and the role of genetic counselors. The program shall encourage inclusion in graduate medical education and continuing medical education—including for specialty oncology services—of training on the importance of molecular diagnostics at cancer diagnosis and recurrence to detect mutations.