Finn Sawyer Access to Cancer Testing Act
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HR 1620 — Finn Sawyer Access to Cancer Testing Act
Last action — 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.
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed House
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4Passed Senate
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5To Executive
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6Enacted
This bill is in committee in the House. Introduced February 26, 2025. It must pass committee before a floor vote.
Next likely step: a committee vote, then a floor vote in the House.
Prognosis
Where this bill stands today.
Odds of enactment
LowHow often bills like it became law.
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In Committee
Current position in the legislative process.
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14 sponsors
1 primary, 13 co-sponsors signed on.
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Bipartisan support
Sponsored across 2 parties (12 D · 2 R) — cross-party backing.
Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.
Summary
Finn Sawyer Access to Cancer Testing Act This bill provides for coverage of certain cancer diagnostic and laboratory tests under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Specifically, the bill provides for coverage of microarray analysis, DNA and RNA sequencing, whole-exome sequencing, and other next-generation sequencing for individuals diagnosed with cancer. Additionally, the Department of Health and Human Services must establish an education and awareness program for physicians and the public about genomic testing and the role of genetic counselors.
Bill Text
- Introduced Introduced in House Current html February 26, 2025
Sections of law this bill changes
5 sections in 1 lawFrom the bill's own amending language, matched to the official United States Code (current through Public Law 119-124).
Social security · 42 U.S.C. ch. 7 5 sections
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§ 1395l Payment of benefits Amends
42 U.S.C. § 1395l
The law today
(a) Amounts Except as provided in section 1395mm of this title, and subject to the succeeding provisions of this section, there shall be paid from the Federal Supplementary Medical Insurance Trust Fund, in the case of each individual who is covered under the insurance program established by this part and incurs expenses for services with respect to which benefits are payable under this part, amounts equal to— (1) in the case of services described in section 1395k(a)(1) of this title—80 percent of the reasonable charges for the services; except that (A) an organization which provides medical and other health services (or arranges for their availability) on a prepayment basis (and either is sponsored by a union or employer, or does not provide, or arrange for the provision of, any inpatient hospital services) may elect to be paid 80 percent of the reasonable cost of services for which payment may be made under this part on behalf of individuals enrolled in such organization in lieu of 80 percent of the reasonable charges for such services if the organization undertakes to charge such individuals no more than 20 percent of such reasonable cost plus any amounts payable by them as a result of subsection (b), (B) with respect to items and services described in section 1395x(s)(10)(A) of this title, the amounts paid shall be 100 percent of the reasonable charges for such items and services, (C) with respect to expenses incurred for those physicians’ services for which payment may be made under this part that are described in section 1395y(a)(4) of this title, the amounts paid shall be subject to such limitations as may be prescribed by regulations, (D) with respect to clinical diagnostic laboratory tests for which payment is made under this part (i)(I) on the basis of a fee schedule under subsection (h)(1) (for tests furnished before January 1, 2017) or subsection (d)(1) or (aa) of section 1395m of this title, the amount paid shall be equal to 80 percent (or 100 percent, in the case of such tests for which payment is made on an assignment-related basis) of the lesser of the amount determined under such fee schedule, the limitation amount for that test determined under subsection (h)(4)(B), or the amount of the charges billed for the tests, or (II) under section 1395m–1 of this title (for tests furnished on or after January 1, 2017), the amount paid shall be equal to 80 percent (or 100 percent, in the case of such tests for which payment is made on an assignment-related basis) of the lesser of the amount determined under such section or the amount of the charges billed for the tests, or (ii) for tests furnished before January 1, 2017, on the basis of a negotiated rate established under subsection (h)(6), the amount paid shall be equal to 100 percent of such negotiated rate,,1 (E) with respect to services furnished to individuals who have been determined to have end stage renal disease, the amounts paid shall be determined subject to the provisions of section 1395rr of this title, (F) with respect to clinical social worker services under section 1395x(s)(2)(N) of this title, the amounts paid shall be 80 percent of the lesser of (i) the actual charge for the services or (ii) 75 percent of the amount determined for payment of a psychologist under clause (L), (G) with respect to facility services furnished in connection with a surgical procedure specified pursuant to subsection (i)(1)(A) and furnished to an individual in an ambulatory surgical center described in such subsection, for services furnished beginning with the implementation date of a revised payment system for such services in such facilities specified in subsection (i)(2)(D), the amounts paid, subject to subsection (i)(9), shall be 80 percent of the lesser of the actual charge for the services or the amount determined by the Secretary under such revised payment system, (H) with respect to services of a certified registered nurse anesthetist under section 1395x(s)(11) of th...412 other bills also change this section · Follow it → Official text at uscode.house.gov ↗
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§ 1395x Definitions Amends
42 U.S.C. § 1395x
The law today
For purposes of this subchapter— (a) Spell of illness The term “spell of illness” with respect to any individual means a period of consecutive days— (1) beginning with the first day (not included in a previous spell of illness) (A) on which such individual is furnished inpatient hospital services, inpatient critical access hospital services or extended care services, and (B) which occurs in a month for which he is entitled to benefits under part A, and (2) ending with the close of the first period of 60 consecutive days thereafter on each of which he is neither an inpatient of a hospital or critical access hospital nor an inpatient of a facility described in section 1395i–3(a)(1) of this title or subsection (y)(1). (b) Inpatient hospital services The term “inpatient hospital services” means the following items and services furnished to an inpatient of a hospital and (except as provided in paragraph (3)) by the hospital— (1) bed and board; (2) such nursing services and other related services, such use of hospital facilities, and such medical social services as are ordinarily furnished by the hospital for the care and treatment of inpatients, and such drugs, biologicals, supplies, appliances, and equipment, for use in the hospital, as are ordinarily furnished by such hospital for the care and treatment of inpatients; and (3) such other diagnostic or therapeutic items or services, furnished by the hospital or by others under arrangements with them made by the hospital, as are ordinarily furnished to inpatients either by such hospital or by others under such arrangements; excluding, however— (4) medical or surgical services provided by a physician, resident, or intern, services described by subsection (s)(2)(K), certified nurse-midwife services, qualified psychologist services, and services of a certified registered nurse anesthetist; and (5) the services of a private-duty nurse or other private-duty attendant. Paragraph (4) shall not apply to services provided in a hospital by— (6) an intern or a resident-in-training under a teaching program approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association, or, in the case of services in a hospital or osteopathic hospital by an intern or resident-in-training in the field of dentistry, approved by the Council on Dental Education of the American Dental Association, or in the case of services in a hospital or osteopathic hospital by an intern or resident-in-training in the field of podiatry, approved by the Council on Podiatric Medical Education of the American Podiatric Medical Association; or (7) a physician where the hospital has a teaching program approved as specified in paragraph (6), if (A) the hospital elects to receive any payment due under this subchapter for reasonable costs of such services, and (B) all physicians in such hospital agree not to bill charges for professional services rendered in such hospital to individuals covered under the insurance program established by this subchapter. (c) Inpatient psychiatric hospital services The term “inpatient psychiatric hospital services” means inpatient hospital services furnished to an inpatient of a psychiatric hospital. (d) Supplier The term “supplier” means, unless the context otherwise requires, a physician or other practitioner, a facility, or other entity (other than a provider of services) that furnishes items or services under this subchapter. (e) Hospital The term “hospital” (except for purposes of sections 1395f(d), 1395f(f), and 1395n(b) of this title, subsection (a)(2) of this section, paragraph (7) of this subsection, and subsection (i) of this section) means an institution which— (1) is primarily engaged in providing, by or under the supervision of physicians, to inpatients (A) diagnostic services and therapeutic services for medical ...553 other bills also change this section · Follow it → Official text at uscode.house.gov ↗
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§ 1395y Exclusions from coverage and medicare as secondary payer Amends
42 U.S.C. § 1395y — at 1395y(a)(1)
The law today
(a) Items or services specifically excluded Notwithstanding any other provision of this subchapter, no payment may be made under part A or part B for any expenses incurred for items or services— (1) (A) which, except for items and services described in a succeeding subparagraph, additional preventive services (as described in section 1395x(ddd)(1) of this title), or multi-cancer early detection screening tests (as defined in section 1395x(nnn) of this title), are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, (B) in the case of items and services described in section 1395x(s)(10) of this title, which are not reasonable and necessary for the prevention of illness, (C) in the case of hospice care, which are not reasonable and necessary for the palliation or management of terminal illness, (D) in the case of clinical care items and services provided with the concurrence of the Secretary and with respect to research and experimentation conducted by, or under contract with, the Medicare Payment Advisory Commission or the Secretary, which are not reasonable and necessary to carry out the purposes of section 1395ww(e)(6) of this title,1 (E) in the case of research conducted pursuant to section 1320b–12 of this title, which is not reasonable and necessary to carry out the purposes of that section, (F) in the case of screening mammography, which is performed more frequently than is covered under section 1395m(c)(2) of this title or which is not conducted by a facility described in section 1395m(c)(1)(B) of this title, in the case of screening pap smear and screening pelvic exam, which is performed more frequently than is provided under section 1395x(nn) of this title, and, in the case of screening for glaucoma, which is performed more frequently than is provided under section 1395x(uu) of this title, (G) in the case of prostate cancer screening tests (as defined in section 1395x(oo) of this title), which are performed more frequently than is covered under such section, (H) in the case of colorectal cancer screening tests, which are performed more frequently than is covered under section 1395m(d) of this title, (I) the frequency and duration of home health services which are in excess of normative guidelines that the Secretary shall establish by regulation, (J) in the case of a drug or biological specified in section 1395w–3a(c)(6)(C) of this title for which payment is made under part B that is furnished in a competitive area under section 1395w–3b of this title, that is not furnished by an entity under a contract under such section, (K) in the case of an initial preventive physical examination, which is performed more than 1 year after the date the individual’s first coverage period begins under part B, (L) in the case of cardiovascular screening blood tests (as defined in section 1395x(xx)(1) of this title), which are performed more frequently than is covered under section 1395x(xx)(2) of this title, (M) in the case of a diabetes screening test (as defined in section 1395x(yy)(1) of this title), which is performed more frequently than is covered under section 1395x(yy)(3) of this title, (N) in the case of ultrasound screening for abdominal aortic aneurysm which is performed more frequently than is provided for under section 1395x(s)(2)(AA) of this title, (O) in the case of kidney disease education services (as defined in paragraph (1) of section 1395x(ggg) of this title), which are furnished in excess of the number of sessions covered under paragraph (4) of such section, and (P) in the case of personalized prevention plan services (as defined in section 1395x(hhh)(1) of this title), which are performed more frequently than is covered under such section; (2) for which the individual furnished such items or services has no legal obligation to pay, and which no other person (by reason of such individual’s membership in a prepayment plan or othe...202 other bills also change this section · Follow it → Official text at uscode.house.gov ↗
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§ 1396d Definitions Amends
42 U.S.C. § 1396d — at 1396d(a)
The law today
For purposes of this subchapter— (a) Medical assistance The term “medical assistance” means payment of part or all of the cost of the following care and services or the care and services themselves, or both (if provided in or after the third month before the month in which the recipient makes application for assistance or, in the case of medicare cost-sharing with respect to a qualified medicare beneficiary described in subsection (p)(1), if provided after the month in which the individual becomes such a beneficiary) for individuals, and, with respect to physicians’ or dentists’ services, at the option of the State, to individuals (other than individuals with respect to whom there is being paid, or who are eligible, or would be eligible if they were not in a medical institution, to have paid with respect to them a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in section 1396a(a)(10)(A) of this title) not receiving aid or assistance under any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV, and with respect to whom supplemental security income benefits are not being paid under subchapter XVI, who are— (i) under the age of 21, or, at the option of the State, under the age of 20, 19, or 18 as the State may choose, (ii) relatives specified in section 606(b)(1) 1 of this title with whom a child is living if such child is (or would, if needy, be) a dependent child under part A of subchapter IV, (iii) 65 years of age or older, (iv) blind, with respect to States eligible to participate in the State plan program established under subchapter XVI, (v) 18 years of age or older and permanently and totally disabled, with respect to States eligible to participate in the State plan program established under subchapter XVI, (vi) persons essential (as described in the second sentence of this subsection) to individuals receiving aid or assistance under State plans approved under subchapter I, X, XIV, or XVI, (vii) blind or disabled as defined in section 1382c of this title, with respect to States not eligible to participate in the State plan program established under subchapter XVI, (viii) pregnant women, (ix) individuals provided extended benefits under section 1396r–6 of this title, (x) individuals described in section 1396a(u)(1) of this title, (xi) individuals described in section 1396a(z)(1) of this title, (xii) employed individuals with a medically improved disability (as defined in subsection (v)), (xiii) individuals described in section 1396a(aa) of this title, (xiv) individuals described in section 1396a(a)(10)(A)(i)(VIII) or 1396a(a)(10)(A)(i)(IX) of this title, (xv) individuals described in section 1396a(a)(10)(A)(ii)(XX) of this title, (xvi) individuals described in section 1396a(ii) of this title, (xvii) individuals who are eligible for home and community-based services under needs-based criteria established under paragraph (1)(A) of section 1396n(i) of this title, or who are eligible for home and community-based services under paragraph (6) of such section, and who will receive home and community-based services pursuant to a State plan amendment under such subsection, or (xviii) individuals who, but for earnings in excess of the limit established under subsection (q)(2)(B), would be considered to be receiving supplemental security income, and who are at least 16 years of age, but whose income and resources are insufficient to meet all of such cost— (1) inpatient hospital services (other than services in an institution for mental diseases); (2) (A) outpatient hospital services, (B) consistent with State law permitting such services, rural health clinic services (as defined in subsection (l)(1)) and any other ambulatory services which are offered by a rural health clinic (as defined in subsection (l)(1)) and which are otherwise included in the plan, and (C) Federally...434 other bills also change this section · Follow it → Official text at uscode.house.gov ↗
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§ 1397cc Coverage requirements for children’s health insurance Amends
42 U.S.C. § 1397cc — at 1397cc(c)
The law today
(a) Required scope of health insurance coverage The child health assistance provided to a targeted low-income child under the plan in the form described in paragraph (1) of section 1397aa(a) of this title shall consist, consistent with paragraphs (5), (6), (7), and (8) of subsection (c), of any of the following: (1) Benchmark coverage Health benefits coverage that is at least equivalent to the benefits coverage in a benchmark benefit package described in subsection (b). (2) Benchmark-equivalent coverage Health benefits coverage that meets the following requirements: (A) Inclusion of basic services The coverage includes benefits for items and services within each of the categories of basic services described in subsection (c)(1). (B) Aggregate actuarial value equivalent to benchmark package The coverage has an aggregate actuarial value that is at least actuarially equivalent to one of the benchmark benefit packages. (C) Substantial actuarial value for additional services included in benchmark package With respect to each of the categories of additional services described in subsection (c)(2) for which coverage is provided under the benchmark benefit package used under subparagraph (B), the coverage has an actuarial value that is equal to at least 75 percent of the actuarial value of the coverage of that category of services in such package. (3) Existing comprehensive State-based coverage Health benefits coverage under an existing comprehensive State-based program, described in subsection (d)(1). (4) Secretary-approved coverage Any other health benefits coverage that the Secretary determines, upon application by a State, provides appropriate coverage for the population of targeted low-income children proposed to be provided such coverage. (b) Benchmark benefit packages The benchmark benefit packages are as follows: (1) FEHBP-equivalent children’s health insurance coverage The standard Blue Cross/Blue Shield preferred provider option service benefit plan, described in and offered under section 8903(1) of title 5. (2) State employee coverage A health benefits coverage plan that is offered and generally available to State employees in the State involved. (3) Coverage offered through HMO The health insurance coverage plan that— (A) is offered by a health maintenance organization (as defined in section 2791(b)(3) of the Public Health Service Act [42 U.S.C. 300gg–91(b)(3)]), and (B) has the largest insured commercial, non-medicaid enrollment of covered lives of such coverage plans offered by such a health maintenance organization in the State involved. (c) Categories of services; determination of actuarial value of coverage (1) Categories of basic services For purposes of this section, the categories of basic services described in this paragraph are as follows: (A) Inpatient and outpatient hospital services. (B) Physicians’ surgical and medical services. (C) Laboratory and x-ray services. (D) Well-baby and well-child care, including age-appropriate immunizations. (E) Mental health and substance use disorder services (as defined in paragraph (5)). (2) Categories of additional services For purposes of this section, the categories of additional services described in this paragraph are as follows: (A) Coverage of prescription drugs. (B) Vision services. (C) Hearing services. (3) Treatment of other categories Nothing in this subsection shall be construed as preventing a State child health plan from providing coverage of benefits that are not within a category of services described in paragraph (1) or (2). (4) Determination of actuarial value The actuarial value of coverage of benchmark benefit packages, coverage offered under the State child health plan, and coverage of any categories of additional services under benchmark benefit packages and under coverage offered by such a plan, shall be set forth in an actuarial opinion in an actuarial report that has been prepared— (A) by an individual who is a member of the American Academy of Act...88 other bills also change this section · Follow it → Official text at uscode.house.gov ↗
Compared against current U.S. Code AI-generated reading aid — verify against the official bill.
The bill adds coverage for cancer diagnostic and laboratory tests under Medicare and Medicaid, defining specific tests and changing payment structures.
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42 U.S.C. 1395x
KK) cancer diagnostic and laboratory tests (as defined in subsection (nnn)) furnished on or after the date that is 6 months after the date of the enactment of this subparagraph.
Adds cancer diagnostic and laboratory tests to the list of covered services under Medicare.
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42 U.S.C. 1395x
nnn) Cancer Diagnostic and Laboratory Tests.--(1) In general.--The term 'cancer diagnostic and laboratory tests' means--(A) microarray analysis, DNA sequencing, RNA sequencing, whole-exome sequencing, and other forms of next-generation sequencing furnished and reported by a clinical laboratory (as defined in section 353(a) of the Public Health Service Act); and(B) explanation and interpretation of any analysis or sequencing described in subparagraph (A); furnished to an individual diagnosed with cancer.
Defines 'cancer diagnostic and laboratory tests' for Medicare coverage.
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42 U.S.C. 1395l
and (13)→ (13), and (14) such deductible shall not apply with respect to cancer diagnostic and laboratory tests (as defined in section 1861(nnn))Removes the deductible for cancer diagnostic and laboratory tests under Medicare.
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42 U.S.C. 1395y(a)(1)
and→ andAmends the exclusions to allow coverage for cancer diagnostic and laboratory tests that are performed as defined.
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42 U.S.C. 1396d
32) cancer diagnostic and laboratory tests (as defined in section 1861(nnn)); and
Adds cancer diagnostic and laboratory tests as a required element of medical assistance under Medicaid.
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42 U.S.C. 1396d
and (30)→ (30), and (32)Establishes mandatory coverage for cancer diagnostic and laboratory tests under Medicaid.
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42 U.S.C. 1397cc
Coverage of cancer diagnostic and laboratory tests.--Regardless of the type of coverage elected by a State under subsection (a), beginning January 1, 2027, child health assistance... shall include coverage of cancer diagnostic and laboratory tests (as defined in section 1861(nnn)).
Includes cancer diagnostic and laboratory tests in the Child Health Insurance Program coverage.
Action History
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Introduced in House
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Introduced in House
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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.
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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.
Sponsors
- Doris O. Matsui · Primary
- Gus M. Bilirakis · Cosponsor
- Mike Thompson · Cosponsor
- Raúl M. Grijalva · Cosponsor
- Don Bacon · Cosponsor
- Debbie Wasserman Schultz · Cosponsor
- Greg Landsman · Cosponsor
- James A. Himes · Cosponsor
- Rashida Tlaib · Cosponsor
- Terri A. Sewell · Cosponsor
- Donald G. Davis · Cosponsor
- Josh Gottheimer · Cosponsor
- Paul Tonko · Cosponsor
- Chellie Pingree · Cosponsor
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 13 co-sponsors · 533 not signed on
Sponsors (1)
- Matsui, Doris O. Democratic
Co-sponsors (13)
- Bilirakis, Gus M. Republican
- Thompson, Mike Democratic
- Grijalva, Raúl M. Democratic
- Bacon, Don Republican
- Wasserman Schultz, Debbie Democratic
- Landsman, Greg Democratic
- Himes, James A. Democratic
- Tlaib, Rashida Democratic
- Sewell, Terri A. Democratic
- Davis, Donald G. Democratic
- Gottheimer, Josh Democratic
- Tonko, Paul Democratic
- Pingree, Chellie Democratic
Not signed on (533)
533 members have not signed on to this bill.
Show all 533 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does HR 1620 do?
- Finn Sawyer Access to Cancer Testing Act This bill provides for coverage of certain cancer diagnostic and laboratory tests under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Specifically, the bill provides for coverage of microarray analysis, DNA and RNA sequencing, whole-exome sequencing, and other next-generation sequencing for individuals diagnosed with cancer. Additionally, the Department of Health and Human Services must establish an education and awareness program for physicians and the public about genomic testing and the role of genetic counselors.
- Who sponsors HR 1620?
- HR 1620 is sponsored by Matsui, Doris O. (Democratic), Bilirakis, Gus M. (Republican), Thompson, Mike (Democratic), Grijalva, Raúl M. (Democratic), Bacon, Don (Republican), Wasserman Schultz, Debbie (Democratic), Landsman, Greg (Democratic), Himes, James A. (Democratic), Tlaib, Rashida (Democratic), Sewell, Terri A. (Democratic), Davis, Donald G. (Democratic), Gottheimer, Josh (Democratic), Tonko, Paul (Democratic), and Pingree, Chellie (Democratic).
- What is the current status of HR 1620?
- This bill is in committee in the House. Introduced February 26, 2025. It must pass committee before a floor vote.
- Where can I track HR 1620?
- Track HR 1620 free on One Click Politics — get push/email alerts when it moves.
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