,,ii #aahth ,,congress #ast ,session ,s4 #gfe ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #i1 #bjbc,ms4 ,murkowski 7for herself and ,mr4 ,cardin7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer1 and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline 7inherited7 mutation associated with a high risk of developing a preventable cancer4 #a4 ,short title ,this ,act may be cited as the ,reducing ,hereditary ,cancer ,act of #bjbc4 #b4 ,hereditary cancer genetic testing of individuals with a family history of a hereditary cancer gene mutation or personal or family history suspicious for hereditary cancer 7a7 ,coverage ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended-- 7#a7 in subsection 7s77#b7-- 7,a7 in subparagraph 7,,ii71 by striking and at the end2 7,b7 in subparagraph 7,,jj71 by inserting and at the end2 and 7,c7 by adding at the end the following new subparagraph3 7,,kk7 in the case of an individual with a personal or family history of a hereditary cancer gene mutation or a personal or family history suspicious for hereditary cancer1 germline mutation testing2 2 and 7#b7 by adding at the end the following new subsection3 7nnn7 ,germline mutation testing ,the term germline mutation testing means genetic testing for germline mutations that is in accordance with evidence-based1 clinical practice guidelines specifically addressing genetic testing1 screening1 and management of individuals with inherited mutations associated with increased cancer risk that-- 7#a7 have been developed by a nationally recognized oncology professional organization1 including the ,national ,comprehensive ,cancer ,network1 the ,american ,society of ,clinical ,oncology1 the ,society of ,gynecologic ,oncology1 or any other oncology professional organization specified by a medicare administrative contractor with a contract under section #ahgd;,a2 and 7#b7 in the case of conflicting guidelines developed by more than one nationally recognized oncology professional organization1 are the least restrictive of such guidelines1 as determined by such a medicare administrative contractor4 4 7b7 ,frequency ,section #ahfb7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciey7a77#a77 is amended-- 7#a7 by striking and at the end of subparagraph 7,o72 7#b7 by adding and at the end of subparagraph 7,p72 and 7#c7 by adding at the end the following new subparagraph3 7,q7 in the case of germline mutation testing as defined in section #ahfa7nnn71 which is performed more than once with respect to an individual described in such section2 4 7c7 ,effective date ,the amendments made by this section shall apply to testing furnished on or after the date of the enactment of this ,act4 #c4 ,coverage of certain preventive surgeries 7a7 ,in general ,section #ahfb of the ,social ,security ,act 7#db ,u4,s4,c4 #aciey7 is amended by adding at the end the following new subsection3 7p7 ,coverage of certain risk-,reducing surgeries ,in the case of an individual described in section #ahfa7s77#b77;,,jj7 for whom1 based on evidence-based1 clinical practice guidelines described in section #ahfa7nnn71 surgery would reduce the risk of developing cancer1 such risk-reducing surgery shall be considered reasonable and necessary for treatment of illness under subsection 7a77#a77;,a74 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall apply to items and services furnished on or after the date of the enactment of this ,act4 #d4 ,coverage of evidence-based screenings for individuals with a hereditary cancer gene mutation 7a7 ,in general ,section #ahfb of the ,social ,security ,act 7#db ,u4,s4,c4 #aciey71 as amended by section #c1 is amended by adding at the end the following new subsection3 7q7 ,coverage of evidence-,based screenings for individuals with a hereditary cancer gene mutation ,in the case of an individual who is determined pursuant to genetic testing to have a hereditary cancer 7germline7 gene mutation1 the ,secretary shall increase any frequency limitations 7or other limitations on coverage otherwise applicable under this title7 for any evidence-based screenings furnished to such individual1 to be in compliance with evidence-based1 clinical practice guidelines described in section #ahfa7nnn71 or as determined appropriate by the ,secretary1 but not less frequently than on an annual basis4 ,for the purposes of this subsection1 evidence-based screenings shall include screening mammography1 breast screening ,,mri1 colonoscopy1 ,,psa testing1 and any additional evidence-based screening modalities appropriate for high-risk individuals as recommended by such guidelines4 4 7b7 ,conforming amendment for screening mammography ,section #ahcd7;c77#b77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7c77#b77;,a77 is amended1 in the matter preceding clause 7i71 by striking subparagraph 7,b7 and inserting subparagraph 7,b7 and section #ahfb7q74 7c7 ,effective date ,the amendments made by this section shall apply to items and services furnished on or after the date of the enactment of this ,act4