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Congressional Daily Record
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May 19, 2026
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Download official Senate Record PDFReturn to issue contextBy Mr. RICKETTS:
S. 4560. A bill to direct the Secretary of Agriculture to publish, on an annual basis, an assessment of United States dependency on the exportation of agricultural commodities to adversarial countries, and for other purposes; to the Committee on Agriculture, Nutrition, and Forestry.
Mr. RICKETTS. Mr. President, I am proud to represent the great State of Nebraska. Agriculture is our No. 1 industry in Nebraska. I am also proud to represent our farmers and ranchers, who are the best in the world. Agriculture is the heart and soul of what we do in the State of Nebraska. We produce the finest products and the safest food. We feed and fuel our great Nation.
challenges. We have seen low commodity prices and high input costs. We have also seen a drought in my State as well as wildfires that are the worst in our State's history—burning over 1 million acres. But our farmers and ranchers, they are tough and resilient. They find ways to come together and get through the tough times, and they contribute to their communities. Despite all of this, they continue to invest to make sure that we have a strong agricultural sector in Nebraska. This is also important for our country, as food security is national security.
Month throughout the entire country. Again, this is our leading industry in Nebraska: the beef industry. We are the leading State for exporting beef—$1.7 billion worth. We are a leader in every category of beef production. In fact, we have over 6 million head of cattle, and the 3 highest beef-producing counties in the country are in Nebraska. We are very proud of our beef industry, and, of course, it is the best tasting beef in the entire world—even if the Presiding Officer doesn't agree with that right now, being from Montana. So we are very, very proud of that.
May is also Renewable Fuels Month. Again, Nebraska is a leader in renewable fuels with 2.2 billion gallons. Not only is this important for creating jobs in our small towns and rural communities, but this is one of the ways that consumers can save money at the pump. The last time I filled up on E10—a 10-percent blend of ethanol—I saved 55 cents a gallon at my local Hy-Vee. It is also a great way to be able to help clean up the environment.
Of course, it is great for our farmers and ranchers. It is also great for our country. There are estimates that our renewable fuels industry that is so great for our corn farmers and soybean farmers also displaces about 640 million barrels of foreign oil. That means we are less dependent on foreign sources of energy. This is, again, a great way for consumers to save money but also for us to strengthen our energy independence—“America First” energy independence. So our homegrown solution is biofuels.
heard good news with regard to potential initial purchases of American agricultural products. U.S. Trade Representative Jamieson Greer said there will be “double-digit billions” of U.S. agricultural products in 2026, 2027, and 2028—maybe $17 billion in each of those years. That is on top of the 25 million metric tons of soybeans that communist China had agreed to buy already, last year in October. That certainly is good news for our farmers.
for those purchases. We recall that in the first Trump administration, they signed the phase 1 trade deal with communist China, but as soon as President Trump was out of office, China reneged on that deal. We have seen them capriciously turn away the cargo ships of our corn. They have delisted our beef processors.
Communist China, at the end of the day, is a bad trading partner. We need to make sure we hold them accountable for the commitments they make, and I expect this administration will do just that. They have a track record of doing it.
In addition, we need to look at diversifying our export markets. That is why I am introducing the MARKET Act. The MARKET Act would instruct the U.S. Department of Agriculture and the U.S. Trade Representative to look at ways we can mitigate our dependence on communist China and to look for new markets. Last year, in the Working Families Tax Cut, we put in an additional $285 million—doubling the amount of money for trade promotion—to be able to find new markets for our farmers and ranchers.
look for new markets and to come back with a report to Congress on how we can further expand those and mitigate the risks of being dependent upon our adversaries like communist China. Do we need to do something with regard to legislative action or regulatory action? This will help make sure that we continue to be able to expand the trade that is so important for our agricultural States, like Nebraska.
overseas. We are the fifth largest ag exporter in the country. These markets overseas are important to our strong economy in Nebraska. My MARKET Act will help make sure we continue to look for opportunities to be able to grow that.
I am proud of our farmers and ranchers. They do a great job of feeding our great Nation. And I am proud to be able to continue to support them here in Washington, DC.
By Mr. BARRASSO (for himself and Ms. Lummis):
S. 4561. A bill to modernize and streamline the permitting process for broadband infrastructure on Federal land, and for other purposes; to the Committee on Energy and Natural Resources.
Mr. BARRASSO. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.
S. 4561
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Closing Long Overdue
Streamlining Encumbrances To Help Expeditiously Generate
Approved Permits Act” or the “CLOSE THE GAP Act”.
SEC. 2. DEFINITIONS.
In this Act:
(1) Communications facility.—The term “communications
facility” has the meaning given the term in section 8705(a)
of the Agriculture Improvement Act of 2018 (43 U.S.C.
1761a(a)).
(2) Communications site.—The term “communications site”
means an area of Federal land available for communications
use.
(3) Communications use.—The term “communications use”
has the meaning given the
term in section 8705(a) of the Agriculture Improvement Act of
2018 (43 U.S.C. 1761a(a)).
(4) Communications use authorization.—The term
“communications use authorization” means an easement,
right-of-way, lease, license, or other authorization granted
by the Secretary concerned to locate or modify a
communications facility on Federal land for the primary
purpose of authorizing the occupancy and use of the Federal
land for communications use.
(5) Cost recovery fee.—The term “cost recovery fee”
means any fee collected by a Federal land management agency
related to—
(A) an application for a communications use authorization;
or
(B) the occupancy and use authorized by a communications
use authorization pursuant to and consistent with authorizing
law.
(6) Covered land.—The term “covered land” means land
managed by the Secretary concerned.
(7) Electronic sf-299.—The term “electronic SF-299”
means a version of Standard Form 299, or a substantially
similar form, that has been digitally modified for online
interaction.
(8) Federal land.—The term “Federal land” means land
under the jurisdiction and management of a Federal land
management agency.
(9) Federal land management agency.—The term “Federal
land management agency” means—
(A) the National Park Service;
(B) the Bureau of Land Management;
(C) the Bureau of Reclamation;
(D) the United States Fish and Wildlife Service;
(E) the Bureau of Indian Affairs; and
(F) the Forest Service.
(10) Organizational unit.—The term “organizational unit”
means—
(A) with respect to Federal land administered by the
Secretary of the Interior—
(i) a State office;
(ii) a district office;
(iii) a field office; or
(iv) a regional office; and
(B) with respect to the Forest Service—
(i) a regional office;
(ii) the headquarters;
(iii) an administrative unit; or
(iv) a ranger district office.
(11) Previously analyzed federal land.—The term
“previously analyzed Federal land” means any Federal land
with respect to which the Secretary concerned has—
(A) granted a communications use authorization; and
(B) conducted sufficient environmental or historical
reviews, as determined by the Secretary concerned.
(12) Secretary concerned.—The term “Secretary concerned”
means—
(A) the Secretary of the Interior, with respect to Federal
land under the jurisdiction and management of the Secretary
of the Interior, acting through, as applicable—
(i) the Commissioner of Reclamation;
(ii) the Director of the National Park Service;
(iii) the Director of the United States Fish and Wildlife
Service;
(iv) the Director of the Bureau of Land Management; and
(v) the Director of the Bureau of Indian Affairs; and
(B) the Secretary of Agriculture, with respect to National
Forest System land, acting through the Chief of the Forest
Service.
(13) Standard form 299.—The term “Standard Form 299”
means the form developed by the Administrator of General
Services under section 6409(b)(2)(A) of the Middle Class Tax
Relief and Job Creation Act of 2012 (47 U.S.C. 1455(b)(2)(A))
or any successor form.
(14) Working group.—The term “working group” means the
Federal Land Management Agency Working Group established by
section 11(a).
SEC. 3. PROMULGATION OF REGULATIONS FOR STREAMLINING
PURPOSES.
(a) Regulations.—Notwithstanding section 6409 of the
Middle Class Tax Relief and Job Creation Act of 2012 (47
U.S.C. 1455), not later than 1 year after the date of
enactment of this Act, the Secretary concerned shall
promulgate regulations—
(1) to ensure, to the maximum extent practicable, that the
process is uniform and standardized across applicable
organizational units;
(2) to require that applications to locate or modify
communications facilities on covered land be considered and
granted on a competitively neutral, technology neutral, and
nondiscriminatory basis; and
(3) to require that the cost recovery fee for locating or
modifying covered facilities on covered land be—
(A) calculated and assessed on an annual basis; and
(B) based solely on costs incurred by the organizational
unit in processing applications and overseeing any
construction related thereto.
(b) Requirements.—The regulations promulgated under
subsection (a) shall—
(1) include procedures for the tracking of applications
described in subsection (a)(1), including—
(A) identifying on a publicly available website the number
of applications—
(i) received;
(ii) approved; and
(iii) denied;
(B) in the case of an application that is denied, requiring
that the applicant be provided with—
(i) a written decision describing the reasons for the
denial; and
(ii) an opportunity to cure or appeal the denial; and
(C) describing the period of time between the receipt of an
application and the issuance of a final decision on an
application; and
(2) provide for minimum lease terms of not less than 30
years for leases with respect to the location of
communications facilities on covered land.
(c) Additional Considerations.—In promulgating regulations
under subsection (a), the Secretary concerned shall
consider—
(1) how discrete reviews in considering an application
described in paragraph (1) of that subsection can be
conducted simultaneously, rather than sequentially, by any
organizational units that must approve the location or
modification; and
(2) how to eliminate overlapping requirements among the
organizational units with respect to the location or
modification of a communications facility on covered land
administered by the organizational units.
(d) Communication of Streamlined Process to Organizational
Units.—The Secretary concerned shall, with respect to the
regulations promulgated under subsection (a)—
(1) communicate the regulations to the applicable
organizational units; and
(2) ensure that those organizational units follow the
regulations.
(e) Savings Provisions.—
(1) Real property authorities.—Nothing in this section
provides any executive agency or organizational unit with any
new leasing or other real property authorities not in
existence before the date of enactment of this Act.
(2) Effect on other laws.—
(A) In general.—Nothing in this section, including any
action taken pursuant to this section, affects a decision or
determination made by any executive agency before the date of
enactment of this Act to sell, dispose of, declare excess or
surplus, lease, reuse, or redevelop any Federal real property
pursuant to title 40, United States Code, the Federal Assets
Sale and Transfer Act of 2016 (40 U.S.C. 1303 note; Public
Law 114-287), or any other law governing real property
activities of the Federal Government.
(B) Agreements.—No agreement entered into pursuant to this
section obligates the Federal Government to hold, control, or
otherwise retain or use real property that may otherwise be
deemed as excess, surplus, or that could otherwise be sold,
leased, or redeveloped.
SEC. 4. DATA COLLECTION PROCEDURES RELATING TO THE PROCESSING
OF APPLICATIONS FOR BROADBAND PROJECT PERMITS
ON FEDERAL LAND; REPORT.
(a) Definition of Applicable Deadline.—In this section,
the term “applicable deadline”, with respect to an
application for a broadband project permit on Federal land,
means the deadline for that application established by
section 6409(b)(3)(A) of the Middle Class Tax Relief and Job
Creation Act of 2012 (47 U.S.C. 1455(b)(3)(A)).
(b) Data Collection Procedures.—Not later than 1 year
after the date of enactment of this Act, the Secretaries
concerned, acting jointly, shall establish standardized
procedures for internally tracking within Federal land
management agencies the following data relating to
applications for broadband project permits on Federal land:
(1) The number of applications that are pending on or after
the applicable deadline.
(2) The number of applications that have been approved by
the applicable deadline.
(3) The number of applications that were approved after the
applicable deadline.
(4) The number of applications that have been denied by the
applicable deadline.
(5) The number of applications that have been denied after
the applicable deadline.
(6) The number of applications that have been withdrawn
before the applicable deadline.
(7) The number of applications that were withdrawn after
the applicable deadline.
(8) The average processing time for applications.
(9) In the case of applications that were approved after
the applicable deadline, the average number of days by which
the approval exceeded the applicable deadline.
(c) Report on Delays in the Approval of Applications for
Broadband Projects on Federal Land.—Not later than 1 year
after the date on which the Secretaries concerned establish
the procedures under subsection (b), the Secretaries
concerned, acting jointly, shall submit to the Committees on
Energy and Natural Resources, Environment and Public Works,
and Agriculture, Nutrition, and Forestry of the Senate and
the Committees on Natural Resources, Energy and Commerce, and
Agriculture of the House of Representatives a report that—
(1) describes and analyzes the data collected in accordance
with those procedures, including an analysis of any factors
causing a delay in the approval of applications for broadband
project permits on Federal land; and
(2) provides recommendations to address any of the factors
identified under paragraph (1) in order to accelerate
broadband project permitting on Federal land.
SEC. 5. ONLINE TRACKING OF APPLICATION PROGRESS.
(a) Sense of Congress.—It is the sense of Congress that
communications projects (as defined in section 41001 of the
FAST Act (42 U.S.C. 4370m)) should be, under title XLI of
the FAST Act (42 U.S.C. 4370m et seq.), considered a high
priority as having an increased regional or national economic
significance.
(b) Communications Projects as Covered Projects.—Section
41001 of the FAST Act (42 U.S.C. 4370m) is amended—
(1) by redesignating paragraphs (4) through (18) as
paragraphs (5) through (19), respectively;
(2) by inserting after paragraph (3) the following:
“(4) Communications project.—
“(A) In general.—The term `communications project' means
any construction project carried out at a communications
site.
“(B) Other terms.—For purposes of this paragraph:
“(i) Communications facility.—The term `communications
facility' has the meaning given the term in section 8705(a)
of the Agriculture Improvement Act of 2018 (43 U.S.C.
1761a(a)).
“(ii) Communications site.—The term `communications site'
means an area of Federal land available for communications
use.
“(iii) Communications use.—The term `communications use'
has the meaning given the term in section 8705(a) of the
Agriculture Improvement Act of 2018 (43 U.S.C. 1761a(a)).
“(iv) Federal land.—The term `Federal land' means land
under the jurisdiction and management of a Federal land
management agency.
“(v) Federal land management agency.—The term `Federal
land management agency' means—
“(I) the National Park Service;
“(II) the Bureau of Land Management;
“(III) the Bureau of Reclamation;
“(IV) the United States Fish and Wildlife Service;
“(V) the Forest Service; and
“(VI) the Bureau of Indian Affairs.”; and
(3) in paragraph (7)(A) (as so redesignated)—
(A) in the matter preceding clause (i), by inserting
“communications projects,” after “carbon capture,”; and
(B) in clause (i), by striking subclause (II) and inserting
the following:
“(II) is likely to require a total investment—
“(aa) in the case of a communications project, of any
amount; and
“(bb) in the case of any other activity, of more than
$200,000,000; and”.
SEC. 6. IMPROVING PUBLIC SAFETY ON FEDERAL LAND.
Not later than 30 days after the date of enactment of this
Act, the Secretary concerned shall direct the head of each
Federal land management agency under the jurisdiction of the
Secretary concerned—
(1) to establish a new categorical exclusion from the
requirements of title I of the National Environmental Policy
Act of 1969 (42 U.S.C. 4331 et seq.) for projects involving
an existing communications facility that would improve public
safety on Federal land, such as—
(A) providing backup power for the communications facility;
(B) improving supporting infrastructure at the
communications facility; or
(C) providing more reliable or redundant connection
capabilities using the communications facility; or
(2) to adopt an existing categorical exclusion from another
agency under section 109 of that Act (42 U.S.C. 4336c)
applicable to projects described in paragraph (1).
SEC. 7. PREVIOUSLY ANALYZED FEDERAL LAND.
(a) Nonapplicability of Certain Review Requirements.—The
review requirements of the National Environmental Policy Act
of 1969 (42 U.S.C. 4321 et seq.) and division A of subtitle
III of title 54, United States Code, shall not apply to an
application for a communications use authorization on Federal
land (including Federal land on which authorized utilities,
communications facilities, powerline facilities, or roads
have been installed), if—
(1) the communications equipment is located in or on
existing infrastructure; or
(2) the communications facility is located on previously
analyzed Federal land.
(b) No Additional Consultation Required Under Certain
Circumstances.—Notwithstanding any other provision of law,
the Secretary concerned shall not be required to reinitiate
consultation under the requirements of the National
Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.) or
division A of subtitle III of title 54, United States Code,
for an application for a communications use authorization on
previously analyzed Federal land, regardless of whether new
information concerning the previously analyzed Federal land
becomes available.
SEC. 8. WIRELESS FACILITY MODIFICATIONS.
Section 6409(a) of the Middle Class Tax Relief and Job
Creation Act of 2012 (47 U.S.C. 1455(a)) is amended by
striking paragraph (3).
SEC. 9. ESTABLISHMENT OF ONLINE PORTALS.
(a) In General.—Not later than 1 year after the date of
enactment of this Act, each Federal land management agency
shall establish an online portal to accept an electronic SF-
(b) Coordination.—The Federal land management agencies
shall coordinate with each other to establish uniform
versions of the online portal required under subsection (a).
SEC. 10. COLLECTION AND RETENTION OF COST RECOVERY FEES.
(a) Collection and Retention of Cost Recovery Fees
Associated With Communications Use Authorizations on Federal
Land and Federal Land Management Agency Support for
Communications Site Programs.—
(1) Special account required.—The Secretary of the
Treasury shall establish a special account in the Treasury
for each Federal land management agency for the deposit of
cost recovery fees received by the Federal land management
agency relating to communications use authorizations granted,
issued, or executed by the Federal land management agency.
(2) Requirements for cost recovery fees.—Notwithstanding
any other provision of law, any cost recovery fees collected
by a Federal land management agency pursuant to this section
shall be—
(A) collected only to the extent provided in advance in an
appropriations Act;
(B) calculated and assessed on an annual basis;
(C) based solely on costs incurred by organizational units
in processing applications for communications use
authorizations and overseeing any applicable construction
activities relating to the communications use authorizations;
and
(D) imposed on a competitively neutral, technology-neutral,
and nondiscriminatory basis with respect to other uses of the
applicable communications site.
(3) Deposit and retention of cost recovery fees.—Cost
recovery fees received by a Federal land management agency
shall—
(A) be deposited in the special account established for
that Federal land management agency under paragraph (1); and
(B) remain available for expenditure under paragraph (4),
to the extent and in such amounts as are provided in advance
in appropriations Acts.
(4) Expenditure of retained fees.—Amounts deposited in the
special account established for a Federal land management
agency under paragraph (1) shall be used by the Federal land
management agency for activities relating to communications
use authorizations or communications sites, including the
following:
(A) Administering communications use authorizations,
including through cooperative agreements under subsection
(b).
(B) Preparing needs assessments or other programmatic
analyses necessary to establish communications sites and
authorize communications uses on or adjacent to Federal land.
(C) Developing management plans for the placement of
communications sites on or adjacent to Federal land on a
competitively neutral, technology-neutral, nondiscriminatory
basis.
(D) Training for management of communications sites on or
adjacent to Federal land.
(E) Obtaining, improving access to, or establishing
communications sites on or adjacent to Federal land.
(F) Hiring and training personnel to perform duties that
will help—
(i) to streamline permitting processes associated with
communications use authorizations and the use of
communications sites for communications use on Federal land;
and
(ii) to reduce the time it takes for permits relating to
communications use authorizations and the use of
communications sites for communications use on Federal land
to be approved.
(5) No effect on other fee retention authorities.—This
subsection shall not limit or otherwise affect fee retention
by a Federal land management agency under any other
authority.
(b) Cooperative Agreement Authority.—The Secretary of the
Interior may enter into cooperative agreements to carry out
the activities described in subsection (a)(4).
SEC. 11. FEDERAL LAND MANAGEMENT AGENCY WORKING GROUP.
(a) Establishment.—There is established a working group,
to be known as the “Federal Land Management Agency Working
Group”.
(b) Membership.—The working group shall be composed of 1
representative of each of the Federal land management
agencies, to be appointed by the Secretary concerned.
(c) Duties.—The working group shall—
(1) periodically meet to coordinate and expedite the review
of applications for communications use authorizations; and
(2) coordinate with the Federal Communications Commission
to use broadband location data created under section 802(c)
of the Communications Act of 1934 (47 U.S.C. 642(c)) to
identify unserved locations that may need to use a Federal
right-of-way and prepare for potential communications use
authorization applications.
By Mr. DURBIN (for himself and Ms. Hirono):
S. 4566. A bill to amend title XIX of the Social Security Act to require coverage under State plans under the Medicaid program for annual lung cancer screening with no cost sharing for individuals for whom screening is recommended by U.S. Preventive Services Task Force guidelines, to expand coverage under Medicaid of counseling and pharmacotherapy for cessation of tobacco use, and for other purposes; to the Committee on Finance.
Mr. DURBIN. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.
S. 4566
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Increasing Access to Lung
Cancer Screening Act”.
SEC. 2. MEDICAID COVERAGE OF ANNUAL LUNG CANCER SCREENING
WITH NO COST SHARING FOR CERTAIN INDIVIDUALS.
(a) In General.—Section 1905(a)(4) of the Social Security
Act (42 U.S.C. 1396d(a)(4)) is amended—
(1) by striking “and” before “(D)”;
(2) by striking “and” before “(E)”;
(3) by striking “and” before “(F)”; and
(4) by inserting before the semicolon at the end the
following: “; and (G) an annual lung cancer screening for
individuals who are eligible under the State plan or under a
waiver of such plan and for whom such screening is
recommended under guidelines published by the United States
Preventive Services Task Force (provided that such guidelines
do not decrease the recommended frequency of lung cancer
screenings for such individuals or narrow the population
recommended for lung cancer screening published by the United
States Preventive Services Task Force on March 9, 2021),
without regard to prior authorization”.
(b) No Cost Sharing.—
(1) In general.—Subsections (a)(2) and (b)(2) of section
1916 of the Social Security Act (42 U.S.C. 1396o) are each
amended—
(A) in subparagraph (I), by striking “or” at the end;
(B) in subparagraph (J), by striking “; and” and
inserting “, or” at the end; and
(C) by adding at the end the following new subparagraph:
“(K) lung cancer screening for which payment may be made
under the State plan or under a waiver of such plan pursuant
section to 1905(a)(4)(G); and”.
(2) Application to alternative cost sharing.—Section
1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o-
1(b)(3)(B)) is amended by adding at the end the following new
clause:
“(xv) Lung cancer screening for which payment may be made
under the State plan or under a waiver of such plan pursuant
to section 1905(a)(4)(G).”.
(c) Application to Medicaid Managed Care Organizations.—
Section 1932(b) of the Social Security Act (42 U.S.C. 1396u-
2(b)) is amended by adding at the end the following new
paragraph:
“(9) Lung cancer screening.—Each contract with a medicaid
managed care organization under section 1903(m) shall require
the organization to provide coverage for lung cancer
screening for which payment may be made under the State plan
or under a waiver of such plan pursuant to section
1905(a)(4)(G) without regard to prior authorization.”.
(d) Effective Date.—
(1) In general.—Subject to paragraph (2), the amendments
made by this section shall apply with respect to items and
services furnished on or after January 1, 2028.
(2) Exception if state legislation required.—In the case
of a State plan for medical assistance under title XIX of the
Social Security Act which the Secretary of Health and Human
Services determines requires State legislation (other than
legislation appropriating funds) in order for the plan to
meet the additional requirements imposed by the amendments
made by this section, the State plan shall not be regarded as
failing to comply with the requirements of such title solely
on the basis of its failure to meet such additional
requirements before the first day of the first calendar
quarter beginning after the close of the first regular
session of the State legislature that begins after the date
of the enactment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year
legislative session, each year of such session shall be
deemed to be a separate regular session of the State
legislature.
SEC. 3. EXPANDING COVERAGE UNDER MEDICAID OF COUNSELING AND
PHARMACOTHERAPY FOR CESSATION OF TOBACCO USE TO
ALL MEDICAID INDIVIDUALS.
(a) In General.—Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended—
(1) in subsection (a)(4)(D)—
(A) by striking “by pregnant women”; and
(B) by inserting “without regard to prior authorization”
after “(as defined in subsection (bb))”; and
(2) in subsection (bb)—
(A) by striking “by pregnant women” each place it
appears;
(B) in paragraph (1), by striking “tobacco use who” and
inserting “tobacco use (including the use of e-cigarettes or
vape pens) by individuals who”; and
(C) in paragraph (2)(A), by striking “with respect to
pregnant women”.
(b) Conforming Amendments.—
(1) Section 1927(d)(2)(F) of the Social Security Act (42
U.S.C. 1396r-8(d)(2)(F)) is amended by striking “, in the
case of pregnant women”.
(2) Section 1916 of the Social Security Act (42 U.S.C.
1396o), as amended by section 2(b)(1), is further amended in
each of subsections (a)(2) and (b)(2)—
(A) in subparagraph (B), by striking “, and counseling and
pharmacotherapy for cessation of tobacco use by pregnant
women (as defined in section 1905(bb)) and covered outpatient
drugs (as defined in subsection (k)(2) of section 1927 and
including nonprescription drugs described in subsection
(d)(2) of such section) that are prescribed for purposes of
promoting, and when used to promote, tobacco cessation by
pregnant women in accordance with the Guideline referred to
in section 1905(bb)(2)(A)”;
(B) in subparagraph (J), by striking “or” at the end;
(C) in subparagraph (K), by striking “; and” at the end
and inserting “, or”; and
(D) by adding at the end the following new subparagraph:
“(L) counseling and pharmacotherapy for cessation of
tobacco use (as defined in section 1905(bb)) and covered
outpatient drugs (as defined in subsection (k)(2) of section
1927 and including nonprescription drugs described in
subsection (d)(2) of such section) that are prescribed for
purposes of promoting, and when used to promote, tobacco
cessation in accordance with the Guideline referred to in
section 1905(bb)(2)(A); and”.
(3) Section 1916A(b)(3)(B) of such Act (42 U.S.C. 1396o-
1(b)(3)(B)), as amended by section 2(b)(2), is further
amended—
(A) in clause (iii), by striking “, and counseling and
pharmacotherapy for cessation of tobacco use by pregnant
women (as defined in section 1905(bb))”; and
(B) by adding at the end the following new clause:
“(xvi) Counseling and pharmacotherapy for cessation of
tobacco use (as defined in section 1905(bb)).”.
(c) Application to Medicaid Managed Care Organizations.—
Section 1932(b) of the Social Security Act (42 U.S.C. 1396u-
2(b)), as amended by section 2(c), is further amended by
adding at the end the following new paragraph:
“(10) Cessation of tobacco use.—Each contract with a
medicaid managed care organization under section 1903(m)
shall require the organization to provide coverage for
counseling and pharmacotherapy for cessation of tobacco use
without regard to prior authorization.”.
(d) Effective Date.—
(1) In general.—Subject to paragraph (2), the amendments
made by this section shall apply with respect to items and
services furnished on or after January 1, 2028.
(2) Exception if state legislation required.—In the case
of a State plan for medical assistance under title XIX of the
Social Security Act which the Secretary of Health and Human
Services determines requires State legislation (other than
legislation appropriating funds) in order for the plan to
meet the additional requirements imposed by the amendments
made by this section, the State plan shall not be regarded as
failing to comply with the requirements of such title solely
on the basis of its failure to meet such additional
requirements before the first day of the first calendar
quarter beginning after the close of the first regular
session of the State legislature that begins after the date
of the enactment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year
legislative session, each year of such session shall be
deemed to be a separate regular session of the State
legislature.
SEC. 4. COVERAGE UNDER MEDICARE AND PRIVATE HEALTH INSURANCE
OF ANNUAL LUNG CANCER SCREENING WITHOUT
UTILIZATION MANAGEMENT REQUIREMENTS.
(a) Medicare.—
(1) In general.—Section 1834 of the Social Security Act
(42 U.S.C. 1395m) is amended by adding at the end the
following new subsection:
“(bb) Special Rule for Annual Lung Cancer Screening.—
Notwithstanding any other provision of this title, in the
case of an annual lung cancer screening for which benefits
are provided under this part for any individual for whom such
screening is recommended in accordance with guidelines issued
by the Secretary, such benefits shall be provided without
application of any prior authorization.”.
(2) Application under medicare advantage.—Section
1852(a)(1)(B) of the Social Security Act (42 U.S.C. 1395w-
22(a)(1)(B)) is amended by adding at the end the following
new clause:
“(vii) Prohibition of application of certain requirements
for annual lung cancer screening.—In the case of an annual
lung cancer screening for which benefits are provided under
part B for any individual for whom such screening is
recommended in accordance with guidelines issued by the
Secretary for purposes of section 1834(bb), an MA plan may
not impose any prior authorization with respect to the
coverage of such screening under such plan.”.
(3) Effective date.—The amendments made by this subsection
shall apply with respect to services furnished on or after
January 1, 2028.
(b) Individual and Group Health Insurance Markets.—
(1) In general.—Section 2713 of the Public Health Service
Act (42 U.S.C. 300gg-13) is amended by adding at the end the
following new subsection:
“(d) Prohibition of Application of Certain Requirements
for Annual Lung Cancer Screening.—A group health plan and a
health insurance issuer offering group or individual health
insurance coverage may not require any prior authorization
with respect to the benefits under such plan or coverage for
an annual lung cancer screening for any individual for whom
such screening is recommended by the United States Preventive
Services Task Force.”.
(2) Effective date.—The amendments made by this subsection
shall apply with respect to plan years beginning on or after
January 1, 2028.
SEC. 5. LUNG CANCER SCREENING EDUCATION AND OUTREACH.
(a) In General.—The Secretary of Health and Human Services
(in this section referred to as the “Secretary”), in
consultation with patient and lung cancer advocacy groups,
shall conduct an education and outreach campaign for purposes
of informing individuals and health care providers of—
(1) the importance of lung cancer screenings; and
(2) the categories of individuals who should receive such
screenings.
(b) Manner of Outreach.—The Secretary may carry out the
campaign described in subsection (a) directly, by contract,
through the issuance of grants, or otherwise. In carrying out
such campaign, the Secretary shall ensure that the campaign
is targeted to reach individuals at high risk of lung cancer.
(c) Funding.—There are authorized to be appropriated
$10,000,000 for each of fiscal years 2028 through 2032 for
purposes of carrying out this section.
SEC. 6. REPORT.
Not later than 1 year after the date of the enactment of
this Act, the Comptroller General of the United States shall
conduct a study and submit to Congress a report on the
demographics of individuals diagnosed with lung cancer and
individuals screened for such cancer. Such report shall
identify—
(1) any segments of the population diagnosed with lung
cancer but not captured in current screening eligibility
guidelines (such as firefighters, veterans, and women under
50 years of age); and
(2) recommendations for how the Federal Government can
improve screening for such cancer among such segments.