Sponsors (3)
The bill expands no-cost PFAS blood testing for Medicare beneficiaries and clears billing barriers to improve clinical screening and public-health surveillance, at the expense of higher federal spending and potential downstream costs and anxiety absent clear clinical guidance.
Medicare beneficiaries can obtain physician-ordered PFAS blood tests with no out-of-pocket cost starting Jan 1, 2028, increasing access to exposure screening for millions of older Americans.
Clinicians and health systems can screen patients for PFAS exposure without billing barriers, making it easier to identify exposed patients and integrate testing into routine care and follow-up.
Covering PFAS testing as a preventive service supports public-health surveillance of toxic exposures, improving data for prevention and remediation efforts.
Expanding Medicare-covered services will increase federal spending and could raise Medicare program costs, creating pressure on premiums or the Medicare Trust Fund.
Widespread testing without clear clinical guidelines may generate follow-up costs, unnecessary procedures, and anxiety for patients who receive results with limited treatment options.
Beneficiaries covered under non‑Medicare plans may demand similar coverage, potentially shifting costs to private insurers or employers and increasing insurance or employer costs.
Based on analysis of 2 sections of legislative text.
Medicare will cover physician‑ordered PFAS blood tests as a preventive service with no beneficiary cost‑sharing for tests on/after January 1, 2028.
Official title: To amend title XVIII of the Social Security Act to provide no-cost coverage for PFAS testing under the Medicare program.
Introduced September 26, 2025 by Debbie Dingell · Last progress September 26, 2025
Adds physician-ordered PFAS blood testing to Medicare’s list of covered preventive services and requires Medicare to pay 100% of the allowed amount (no cost-sharing) for those tests beginning January 1, 2028. The law defines “PFAS testing” as a physician‑ordered blood test to determine PFAS concentrations and updates Medicare payment rules so beneficiaries owe no coinsurance or deductibles for tests performed on or after that date. The amendment changes the statutory definitions and preventive-services list in 42 U.S.C. §1395x and adjusts the Medicare payment provision in 42 U.S.C. §1395l(a)(1) to make Medicare cover PFAS testing at the full allowed amount (lesser of actual charge or preventive fee schedule) starting in 2028.