,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #hhde  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,decemb] #c1 #bjbj,ms4
 ,sewell ( ,alabama 7= h]self1 ,mr4     
,arr+ton1 ,mr4 ,ruiz1 & ,mr4 ,hudson7   
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to provide =     
,m$ic>e cov]age ( multi-canc] e>ly      
detection scre5+ te/s4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,m$ic>e       
,multi-,canc] ,e>ly ,detection ,scre5+  
,cov]age ,act ( #bjbj4  #b4 ,f9d+s2     
purpose  7a7 ,f9d+s ,congress f9ds !    
foll[+3 7#a7 ,detect+ canc] e>ly1 be=e x
 has spread ?r\gh\t ! body1 saves lives4
 ,canc]s detect$ :5 /ill localiz$ c be  
treat$ m effectively & h a #e-ye> canc] 
specific survival ( approximately #ij   

p]c5t comp>$ ) approximately #bj p]c5t =
 canc]s f\nd aft] meta/asis has occurr$4
 ,exi/+ ,m$ic>e-cov]$ e>ly detection    
te/s su* z mammograms & colonoscopies1 h
 l$ to a sub/antial r$uction 9          
age-adju/$ mortality4  7#b7 ,diagnos+ & 
treat+ canc] e>li] (t5 results 9 less   
invasive treatm5ts = pati5ts1 :i* are   
also less exp5sive4 ,accord+ to pe]     
review$ lit]ature1 treatm5t ( meta/atic 
canc] is two times m co/ly ?an treatm5t 
( canc] be=e x meta/asizes4  7#c7 ,driv+
 national /rategies to broadly detect   
canc] e>li] w help r$uce p]vasive heal? 
disp>ities s9ce racial1 e?nic1 &        
geographic gr\ps exp]i5ce lat] /ages (  
diagnosis1 along ) high] canc] incid5ce 
& mortality4  7#d7 ,! b5efits ( e>ly    
canc] detection to ,m$ic>e b5efici>ies  
has be5 limit$ to five canc]s4 ,accord+ 
to ! ,national ,canc] ,in/itute's       
,surveillance1 ,epidemiology1 & ,end    
,results program1 #ga p]c5t ( ! #fjj1jjj
 canc] dea?s ea* ye> are f types ( canc]
 )\t a ,m$ic>e-cov]$ e>ly detection te/4

  7#e7 ,age is ! lead+ risk factor =    
canc]1 plac+ ,m$ic>e b5efici>ies at     
elevat$ risk4 ,am]icans :o are #fe ye>s 
( age & old] are m ?an #g times z likely
 z ,am]icans :o are "u #fe ye>s ( age to
 be diagnos$ ) canc]4  7#f7 ,sev]al     
innovative private & academic ef=ts are 
engag$ 9 rese>*1 includ+ advanc$ cl9ical
 trials to develop multi-canc] e>ly     
detection blood-bas$ te/s4 ,publi%$ data
 indicate t ^! te/s c scre5 = _m canc]s 
at ! same "t1 includ+ r>e canc]s1 ) "o  
example curr5tly able to scre5 = m ?an  
#ej canc]s4  7#g7 ,multi-canc] e>ly     
detection te/s c complem5t ! cov]$ e>ly 
detection te/s enact$ by ,congress &    
ext5d ! b5efits ( e>ly detection to m   
canc]s & m ,am]icans4 ,m$ic>e cov]age ( 
compreh5sive multi-canc] e>ly detection 
scre5+ te/s c\ld sub/antially trans=m   
canc] c>e = ,am]icans1 & ! ,m$ic>e law  
ne$s mod]niz+ to provide timely cov]age 
& keep pace ) m$ical innovation4  7b7   
,purpose ,! purpose ( ?is ,act is to    
create a cov]$ b5efit = multi-canc] e>ly

 detection scre5+ te/s to ensure ,m$ic>e
 b5efici>y access to ^! te/s )\t        
unnecess>y delay once approv$ "u !      
,f$]al ,food1 ,drug1 & ,cosmetic ,act4  
#c4 ,m$ic>e cov]age ( multi-canc] e>ly  
detection scre5+ te/s  7a7 ,cov]age     
,section #ahfa ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciex7 is am5d$--  
7#a7 9 subsection 7s77#b7-- 7,a7 by     
/rik+ & at ! end ( subp>agraph 7,,gg72  
7,b7 by /rik+ ! p]iod at ! end (        
subp>agraph 7,,hh7 & ins]t+ 2 &2 &  7,c7
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,,ii7 multi-canc] e>ly   
detection scre5+ te/s 7z def9$ 9        
subsection 7kkk772  2 &  7#b7 by add+ at
 ! end ! foll[+ new subsection3  7kkk7  
,multi-,canc] e>ly detection scre5+ te/s
 ,! t]m multi-canc] e>ly detection      
scre5+ te/ means any ( ! foll[+ te/s1   
approv$ or cle>$ by ! ,food & ,drug     
,adm9i/ration1 furni%$ to an individual 
= ! purpose ( e>ly detection ( canc]    
across _m canc] types 7z categoriz$ 9 ! 
,annual ,report to ! ,nation on ! ,/atus

 ( ,canc] issu$ by ! ,national ,canc]   
,in/itute73 7#a7 ,a g5omic sequ5c+ blood
 or blood product te/ t includes !      
analysis ( cell-free nucleic acids4     
7#b7 ,su* o!r equival5t te/s 7:i* are   
bas$ on ur9e or o!r sample ( biological 
mat]ial7 z ! ,secret>y det]m9es         
appropriate4  4  7b7 ,paym5t & frequ5cy 
limit  7#a7 ,paym5t "u fee s*$ule       
,section #ahcc7;h7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciel7h77 is      
am5d$-- 7,a7 9 p>agraph 7#a77;,a71 by   
ins]t+ aft] 7includ+ ! foll[+3          
multi-canc] e>ly detection scre5+ te/s  
"u section #ahfa7kkk7 & includ+2 &  7,b7
 by add+ at ! end ! foll[+ new p>agraph3
  7#aj7 ,no paym5t may be made "u ?is "p
 = a multi-canc] e>ly detection scre5+  
te/ 7z def9$ 9 section #ahfa7kkk77 = an 
individual if su* a te/ 0 furni%$ to !  
individual dur+ ! previ\s #aa mon?s4  4 
7#b7 ,con=m+ am5dm5t ,section #ahfb7;a7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciey7a77 is am5d$-- 7,a7 9  
p>agraph 7#a7-- 7i7 9 subp>agraph 7,o71 

by /rik+ & at ! end2  7ii7 9 subp>agraph
 7,p71 by /rik+ ! semicolon at ! end &  
ins]t+ 1 &2 &  7iii7 by add+ at ! end ! 
foll[+ new subp>agraph3  7,q7 9 ! case (
 multi-canc] e>ly detection scre5+ te/s 
7z def9$ 9 section #ahfa7kkk771 :i* are 
p]=m$ m frequ5tly ?an is cov]$ "u       
section #ahcc7;h77#aj72  2 &  7,b7 9    
p>agraph 7#g71 by /rik+ or 7,p7 & ins]t+
 7,p71 or 7,q74  7c7 ,rule ( con/ruction
 relat+ to o!r canc] scre5+ te/s ,no?+ 9
 ?is section1 includ+ ! am5dm5ts made by
 ?is section1 %all be con/ru$-- 7#a7 9 !
 case ( an individual :o und]goes a     
multi-canc] e>ly detection scre5+ te/1  
to affect cov]age "u "p ,b = o!r canc]  
scre5+ te/s cov]$ "u ?is title1 su* z   
scre5+ te/s = brea/1 c]vical1           
colorectal1 lung1 or pro/ate canc]2 or  
7#b7 9 ! case ( an individual :o        
und]goes ano!r canc] scre5+ te/1 to     
affect cov]age = a multi-canc] e>ly     
detection scre5+ te/ or ! use ( su* a   
te/ z a diagno/ic or confirmatory te/ = 
a result ( ! o!r canc] scre5+ te/4