PREFERRED Screening Act

This bill, known as the PREFERRED Screening Act, amends Title XI of the Social Security Act to establish a new payment model. The model's primary purpose is to reimburse eligible healthcare providers for furnishing comprehensive breast cancer risk assessments and developing personalized screening and risk-reduction plans for eligible individuals. This initiative seeks to test the impact of such reimbursement on the provision of breast cancer screening and risk-reduction services. The comprehensive risk assessments will collect detailed information, including genetic testing results (e.g., BRCA1, BRCA2), polygenic risk scores, family history, breast density, and lifestyle factors. Using validated risk models, individuals will be assigned to specific risk categories, including high-risk and elevated-risk. The personalized plans will then provide recommendations for adjusted screening frequency and modality, referrals for enhanced surveillance, and counseling on modifiable risk factors and endocrine risk-reducing medications. The model allows for both traditional in-person office visits and remote means for assessments, including mailed genetic testing kits. The Secretary is directed to select a diverse mix of participating providers, prioritizing those in areas with high breast cancer mortality rates, health professional shortages, or medically underserved populations. Payment amounts will consider the clinical time, complexity of services, and interpretation of genetic data. The Secretary will evaluate the model over its seven-year duration using various primary, secondary, and exploratory measures. These measures include the proportion of individuals assessed, adherence to recommended services, utilization of specific screenings and medications, and the model's cost-effectiveness. Interim and final reports will be submitted to Congress and other relevant bodies, with the final report including recommendations for expansion or permanency.