Ways and Means Committee, Energy and Commerce Committee
Introduced
In Committee
On Floor
Passed Chamber
Enacted
This bill aims to expand coverage under Medicare Part B to include services furnished by genetic counselors. It specifically amends the Social Security Act to add "covered genetic counseling services" to the list of Medicare-eligible benefits, effective for services provided on or after January 1, 2027. This expansion seeks to improve access to specialized genetic health information and support for beneficiaries. The legislation defines covered genetic counseling services as those provided by a qualified genetic counselor, along with incident services, that are legally authorized under state law and would otherwise be covered if furnished by a physician. A genetic counselor is defined as an individual who is either state-licensed or, in states without licensure, certified by the American Board of Genetic Counseling and meets additional criteria set by the Secretary of Health and Human Services. For these newly covered services, Medicare Part B will pay 80 percent of the lesser of the actual charge or 85 percent of the fee schedule amount that would apply if a physician provided the service. The bill also applies Medicare's balance billing rules to genetic counselors and includes a rule of construction to ensure that existing coverage for genetic counseling services provided by physicians remains unaffected by these changes.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
This bill aims to expand coverage under Medicare Part B to include services furnished by genetic counselors. It specifically amends the Social Security Act to add "covered genetic counseling services" to the list of Medicare-eligible benefits, effective for services provided on or after January 1, 2027. This expansion seeks to improve access to specialized genetic health information and support for beneficiaries. The legislation defines covered genetic counseling services as those provided by a qualified genetic counselor, along with incident services, that are legally authorized under state law and would otherwise be covered if furnished by a physician. A genetic counselor is defined as an individual who is either state-licensed or, in states without licensure, certified by the American Board of Genetic Counseling and meets additional criteria set by the Secretary of Health and Human Services. For these newly covered services, Medicare Part B will pay 80 percent of the lesser of the actual charge or 85 percent of the fee schedule amount that would apply if a physician provided the service. The bill also applies Medicare's balance billing rules to genetic counselors and includes a rule of construction to ensure that existing coverage for genetic counseling services provided by physicians remains unaffected by these changes.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.