,,ii  #aai? ,,congress  #a/ ,session    
,s4 #bgfj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #aj1         
#bjbe,ms4 ,murk[ski 7= h]self & ,ms4    
,slotk97 introduc$ ! foll[+ bill2 :i* 0 
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide h]$it>y canc] g5etic te/+ =     
individuals ) a hi/ory ( a h]$it>y canc]
 g5e mutation 9 a blood relative or a   
p]sonal or ance/ral hi/ory suspici\s =  
h]$it>y canc]1 & to provide cov]age (   
c]ta9 canc] scre5+s or prev5tive        
surg]ies t w\ld r$uce ! risk =          
individuals ) a g]ml9e 7inh]it$7        
mutation associat$ ) a high risk (      
develop+ a prev5table canc]4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,r$uc+  
,h]$it>y ,canc] ,act ( #bjbe4  #b4      
,h]$it>y canc] g5etic te/+ ( individuals
 ) a family hi/ory ( a h]$it>y canc] g5e
 mutation or p]sonal or family hi/ory   
suspici\s = h]$it>y canc]  7a7 ,cov]age 
,section #ahfa ( ! ,social ,security    

,act 7#db ,u4,s4,c4 #aciex7 is am5d$--  
7#a7 9 subsection 7s77#b7-- 7,a7 9      
subp>agraph 7,,jj71 by ins]t+ & at !    
end2 &  7,b7 by add+ at ! end ! foll[+  
new subp>agraph3  7,,kk7 9 ! case ( an  
individual ) a p]sonal or family hi/ory 
( a h]$it>y canc] g5e mutation or a     
p]sonal or family hi/ory suspici\s =    
h]$it>y canc]1 g]ml9e mutation te/+2  2 
&  7#b7 by add+ at ! end ! foll[+ new   
subsection3  7nnn7 ,g]ml9e mutation te/+
 ,! t]m g]ml9e mutation te/+ means      
g5etic te/+ = g]ml9e mutations t is 9   
accordance ) evid5ce-bas$1 cl9ical      
practice guidel9es specifically address+
 g5etic te/+1 scre5+1 & managem5t (     
individuals ) inh]it$ mutations         
associat$ ) increas$ canc] risk t-- 7#a7
 h be5 develop$ by a nationally         
recogniz$ oncology pr(essional          
organization1 includ+ ! ,national       
,compreh5sive ,canc] ,network1 !        
,am]ican ,society ( ,cl9ical ,oncology1 
! ,society ( ,gynecologic ,oncology1 or 
any o!r oncology pr(essional            

organization specifi$ by a m$ic>e       
adm9i/rative contractor ) a contract "u 
section #ahgd;,a2 &  7#b7 9 ! case (    
conflict+ guidel9es develop$ by m ?an "o
 nationally recogniz$ oncology          
pr(essional organization1 are ! lea/    
re/rictive ( su* guidel9es1 z det]m9$ by
 su* a m$ic>e adm9i/rative contractor4  
4  7b7 ,frequ5cy ,section #ahfb7;a77#a7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciey7a77#a77 is am5d$-- 7#a7
 by /rik+ & at ! end ( subp>agraph 7,o72
  7#b7 by add+ & at ! end ( subp>agraph 
7,p72 &  7#c7 by add+ at ! end ! foll[+ 
new subp>agraph3  7,q7 9 ! case ( g]ml9e
 mutation te/+ z def9$ 9 section        
#ahfa7nnn71 :i* is p]=m$ m ?an once )   
respect to an individual describ$ 9 su* 
section2  4  7c7 ,effective date ,!     
am5dm5ts made by ?is section %all apply 
to te/+ furni%$ on or aft] ! date ( !   
enactm5t ( ?is ,act4  #c4 ,cov]age (    
c]ta9 prev5tive surg]ies  7a7 ,9 g5]al  
,section #ahfb ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciey7 is am5d$ by 

add+ at ! end ! foll[+ new subsection3  
7p7 ,cov]age ( c]ta9 risk-,r$uc+        
surg]ies ,9 ! case ( an individual      
describ$ 9 section #ahfa7s77#b77,,kk7 = 
:om1 bas$ on evid5ce-bas$1 cl9ical      
practice guidel9es describ$ 9 section   
#ahfa7nnn71 surg]y w\ld r$uce ! risk (  
develop+ canc]1 su* risk-r$uc+ surg]y   
%all be consid]$ reasonable & necess>y =
 treatm5t ( illness "u subsection       
7a77#a77;,a74  4  7b7 ,effective date ,!
 am5dm5t made by subsection 7a7 %all    
apply to items & s]vices furni%$ on or  
aft] ! date ( ! enactm5t ( ?is ,act4    
#d4 ,cov]age ( evid5ce-bas$ scre5+s =   
individuals ) a h]$it>y canc] g5e       
mutation  7a7 ,9 g5]al ,section #ahfb ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciey71 z am5d$ by section #c1 is am5d$
 by add+ at ! end ! foll[+ new          
subsection3  7q7 ,cov]age (             
evid5ce-,bas$ scre5+s = individuals ) a 
h]$it>y canc] g5e mutation ,9 ! case (  
an individual :o is det]m9$ pursuant to 
g5etic te/+ to h a h]$it>y canc]        

7g]ml9e7 g5e mutation1 ! ,secret>y %all 
increase any frequ5cy limitations 7or   
o!r limitations on cov]age o!rwise      
applicable "u ?is title7 = any          
evid5ce-bas$ scre5+s furni%$ to su*     
individual1 to be 9 compliance )        
evid5ce-bas$1 cl9ical practice guidel9es
 describ$ 9 section #ahfa7nnn71 or z    
det]m9$ appropriate by ! ,secret>y1 b n 
less frequ5tly ?an on an annual basis4  
,= ! purposes ( ?is subsection1         
evid5ce-bas$ scre5+s %all include scre5+
 mammography1 brea/ scre5+ ,,mri1       
colonoscopy1 ,,psa te/+1 & any          
additional evid5ce-bas$ scre5+          
modalities appropriate = high-risk      
individuals z recomm5d$ by su*          
guidel9es4  4  7b7 ,con=m+ am5dm5t =    
scre5+ mammography ,section             
#ahcd7;c77#b77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciem7c77#b77;,a77
 is am5d$1 9 ! matt] prec$+ clause 7i71 
by /rik+ subp>agraph 7,b7 & ins]t+      
subp>agraph 7,b7 & section #ahfb7q74    
7c7 ,effective date ,! am5dm5ts made by 

?is section %all apply to items &       
s]vices furni%$ on or aft] ! date ( !   
enactm5t ( ?is ,act4