Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act

This bill seeks to amend the Social Security Act to establish Medicare coverage for multi-cancer early detection screening tests . These tests are defined as those designed for the concurrent detection of multiple cancer types across various organ sites, with coverage becoming available on or after January 1, 2028. To be covered, a test must be cleared, classified, or approved by the Food and Drug Administration and deemed by the Secretary of Health and Human Services to be reasonable, necessary, and appropriate for Medicare beneficiaries. The legislation outlines specific payment amounts and limitations for these new screening tests, initially comparable to a multi-target stool screening DNA test, with future adjustments. Coverage is subject to age restrictions, starting at 68 years in 2028 and increasing annually, and a frequency limit of no more than once every 11 months. These payment and limitation provisions will cease to apply if a multi-cancer early detection screening test receives an A or B recommendation from the United States Preventive Services Task Force . The bill also clarifies that its provisions do not affect Medicare coverage for other existing cancer screening tests or their use as diagnostic tools.