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Adds a new subsection (p) to 42 U.S.C. 1395y providing that, for individuals described in section 1861(s)(2)(II) for whom evidence-based clinical practice guidelines in section 1861(lll) indicate surgery would reduce cancer risk, such risk-reducing surgery shall be considered reasonable and necessary for treatment of illness under subsection (a)(1)(A).
Amends section 1861 (42 U.S.C. 1395x) by adding a new coverage subparagraph (KK) in subsection (s)(2) to cover germline mutation testing for individuals with a personal or family history of a hereditary cancer gene mutation or a history suspicious for hereditary cancer, and by adding a new subsection (nnn) defining the term 'Germline mutation testing' and specifying guideline sources and conflict-resolution rules.
Conforming amendment to 42 U.S.C. 1395m(c)(2)(A) inserting a reference to new section 1862(q) alongside the existing reference to subparagraph (B).
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.
Introduced July 23, 2025 by Debbie Wasserman Schultz · Last progress July 23, 2025
Reducing Hereditary Cancer Act of 2025
This bill makes Medicare cover more care for people at high risk of hereditary cancer. It requires Medicare to pay for genetic testing for inherited (germline) cancer risks when someone has a blood relative with a known cancer gene mutation, or has a personal, family, or ancestral history that suggests hereditary cancer. The testing must follow evidence-based guidelines from major cancer groups; if guidelines conflict, Medicare uses the least restrictive standard so more people who need testing can get it.
If testing shows a hereditary cancer gene mutation, Medicare must also cover regular, evidence-based screenings more often—at least once a year—such as mammograms, breast MRIs, colonoscopies, PSA tests, and other recommended tests for high-risk people. The bill also makes Medicare cover certain risk‑reducing surgeries when trusted guidelines say surgery would lower the chance of developing cancer. These changes take effect for care provided on or after the day the bill becomes law .
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