,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #ihbc  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #bb1 #bjbf,mr4  
,au*9closs 7= himself & ,mr4 ,ciscomani7
 introduc$ ! foll[+ bill2 :i* 0 ref]r$  
to ! ,committee on ,en]gy & ,comm]ce  ,a
 ,,bill  ,to am5d title ,,xxvii ( !     
,public ,heal? ,s]vice ,act & title     
,,xix ( ! ,social ,security ,act to     
require cov]age ( ,alzheim]'s biom>k]   
te/+ "u gr\p heal? plans1 gr\p &        
individual heal? insurance cov]age1 & ! 
,m$icaid program4  #a4 ,%ort title ,?is 
,act may be cit$ z ! ,alzheim]'s ,e>ly  
,detection ,act ( #bjbf4  #b4 ,requir+  
cov]age ( ,alzheim]'s biom>k] te/+ "u   
gr\p heal? plans1 gr\p & individual     
heal? insurance cov]age1 & ! ,m$icaid   
program  7a7 ,private insurance  7#a7 ,9
 g5]al ,"p ,a ( title ,,xxvii ( !       
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;gg-#aa et seq47 is am5d$ 
by add+ at ! end ! foll[+ new section3  
#bgcj4 ,requir$ cov]age ( ,alzheim]'s   
biom>k] te/+  7a7 ,9 g5]al ,a gr\p heal?

 plan & a heal? insurance issu] (f]+    
gr\p or individual heal? insurance      
cov]age %all provide b5efits "u su* plan
 or cov]age = ,alzh]im]'s biom>k] te/+4 
7b7 ,mann] ( cov]age ,a gr\p heal? plan 
& a heal? insurance issu] (f]+ gr\p or  
individual heal? insurance cov]age %all 
ensure t1 ) respect to te/+ = :i*       
b5efits are requir$ to be provid$ "u su*
 plan or cov]age "u subsection 7a7--    
7#a7 ! f9ancial requirem5ts applicable  
to su* te/+ are no m re/rictive ?an !   
pr$om9ant f9ancial requirem5ts appli$ to
 sub/antially all m$ical & surgical     
b5efits cov]$ by ! plan or cov]age & !re
 are no sep>ate co/-%>+ requirem5ts t   
are applicable only ) respect to su*    
te/+2  7#b7 ! treatm5t limitations      
applicable to su* te/+ are no m         
re/rictive ?an ! pr$om9ant treatm5t     
limitations appli$ to sub/antially all  
m$ical & surgical b5efits cov]$ by !    
plan or cov]age & !re are no sep>ate    
treatm5t limitations t are applicable   
only ) respect to su* te/+2  7#c7 9 !   

case su* plan or cov]age imposes any    
prior au?orization requirem5t ) respect 
to su* te/+1 ! plan or cov]age makes a  
det]m9ation ) respect to a reque/ = su* 
au?orization n lat] ?an #gb h\rs 7or #bd
 h\rs1 9 ! case ! provid] submitt+ su*  
reque/ atte/s t delay ( su* te/+ beyond 
#bd h\rs w\ld place an individual's life
 or heal? at s]i\s risk7 aft] receiv+   
su* reque/2  7#d7 9 ! case su* plan or  
cov]age fails to make a det]m9ation )   
respect to a prior au?orization reque/ =
 su* te/+ 9 accordance ) p>agraph 7#c71 
! plan or cov]age treats su* reque/ z   
hav+ be5 approv$2  7#e7 ! plan or       
cov]age does n apply any /ep !rapy      
requirem5t prior to provid+ b5efits =   
su* te/+2 &  7#f7 su* b5efits are       
provid$ 9 a mann] t promotes equitable  
access1 includ+ = rural & und]s]v$      
populations1 & supports ! use ( m9imally
 invasive te/+ :]e cl9ically            
appropriate4  7c7 ,alzheim]'s biom>k]   
te/+ def9$  7#a7 ,9 g5]al ,= purposes ( 
?is section1 ! t]m ,alzheim]'s biom>k]  

te/+ means ! analysis ( an individual's 
tissue1 blood1 or o!r biospecim5 = !    
pres5ce ( a biom>k]1 includ+            
s+le-analyte te/s1 multiplex panel te/s1
 prote9 expression1 & :ole g5ome1 :ole  
exome1 & :ole transcriptome sequ5c+1    
furni%$ = a purpose specifi$ 9 p>agraph 
7#b7-- 7,a7 9 accordance ) any ,food &  
,drug ,adm9i/ration label+ indication2  
7,b7 to det]m9e eligibility =1 or to    
manage treatm5t ( ,alzheim]'s disease )1
 a drug approv$ by ! ,food & ,drug      
,adm9i/ration2  7,c7 9 accordance ) any 
national cov]age det]m9ation "u title   
,,xviii ( ! ,social ,security ,act2 or  
7,d7 9 accordance ) applicable cl9ical  
practice guidel9es or cons5sus /atem5ts 
relat+ to ! diagnosis (1 treatm5t       
selection =1 managem5t (1 or monitor+ ( 
,alzheim]'s disease4  7#b7 ,purposes    
specifi$ ,= purposes ( p>agraph 7#a71 ! 
purposes specifi$ 9 ?is p>agraph are !  
e>ly detection1 risk /ratification1     
diagnosis1 treatm5t1 appropriate        
managem5t1 or ongo+ monitor+ (          

,alzheim]'s disease4  7#c7 ,additional  
def9itions ,= purposes ( p>agraph 7#a73 
7,a7 ,biom>k] ,! t]m biom>k] means a    
*>act]i/ic t is objectively measur$ &   
evaluat$ z an indicator ( normal        
biological processes1 pa?og5ic          
processes1 or ph>macologic responses to 
a specific !rapeutic int]v5tion1 includ+
 g5e-drug int]actions4  7,b7 ,cons5sus  
/atem5t ,! t]m cons5sus /atem5t means   
/atem5ts develop$ by an indep5d5t1      
multidiscipl9>y panel ( exp]ts t uses a 
transp>5t me?odology & report+ /ructure 
& include a conflict-(-int]e/ policy4   
7,c7 ,cl9ical practice guidel9e ,! t]m  
cl9ical practice guidel9e means an      
evid5ce-bas$ guidel9e develop$ by an    
indep5d5t organization or m$ical        
pr(essional society t uses a transp>5t  
me?odology & report+ /ructure & includes
 a conflict-(-int]e/ policy4  4  7#b7   
,effective date ,! am5dm5t made by ?is  
subsection %all apply ) respect to plan 
ye>s beg9n+ on or aft] ! date t is #a   
ye> aft] ! date ( ! enactm5t ( ?is ,act4

  7b7 ,m$icaid  7#a7 ,inclusion z m$ical
 assi/ance ,section #aije7;a7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7a77 is am5d$--  7,a7 9 p>agraph 
7#ca71 by /rik+ & at ! end2  7,b7 by    
r$esignat+ p>agraph 7#cb7 z p>agraph    
7#cc72 &  7,c7 by ins]t+ aft] p>agraph  
7#ca7 ! foll[+ new p>agraph3  7#cb7     
biom>k] te/+ 7z def9$ 9 section         
#bgcj7;c7 ( ! ,public ,heal? ,s]vice    
,act72 &  4  7#b7 ,m&atory cov]age      
,section #aijb7;a77#aj77;,a7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#acie;a7a77#aj77;,a77 is am5d$1 9 !     
matt] prec$+ clause 7i71 by /rik+ &     
7#cj7 & ins]t+ 7#cj71 & 7#cb74  7#c7    
,mann] ( cov]age ,section #aijb7;a7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77 is am5d$--  7,a7 9 p>agraph 
7#hi71 by /rik+ & at ! end2  7,b7 9     
p>agraph 7#ij71 by /rik+ ! p]iod at !   
end & ins]t+ 2 &2 &  7,c7 by ins]t+ aft]
 p>agraph 7#ij7 ! foll[+ new p>agraph3  
7#ia7 provide1 9 ! case ( biom>k] te/+  
7z def9$ 9 subsection 7c7 ( section     

#bgcj ( ! ,public ,heal? ,s]vice ,act71 
= cov]age ( su* te/+ 9 ! same mann] z   
su* te/+ is requir$ to be cov]$ by a    
gr\p heal? plan or heal? insurance issu]
 (f]+ gr\p or individual heal? insurance
 cov]age "u subsection 7b7 ( su*        
section4  4  7#d7 ,effective date ,!    
am5dm5ts made by ?is subsection %all    
apply ) respect to cal5d> qu>t]s beg9n+ 
on or aft] ! date t is #a ye> aft] !    
date ( ! enactm5t ( ?is ,act4  7c7      
,report ,n lat] ?an #a ye> aft] ! date (
 ! enactm5t ( ?is ,act1 & on an annual  
basis = ! #b succe$+ ye>s1 ! ,director (
 ! ,national ,in/itutes ( ,heal? %all1  
?r\gh contract ) ! ,national ,academies 
( ,sci5ces1 ,eng9e]+1 & ,m$ic9e1 conduct
 a /udy & submit to ,congress a report  
on ! value ( biom>k] te/+ 9 detect+ &   
treat+ ,alzheim]'s disease4