,,ii  #aai? ,,congress  #a/ ,session    
,s4 #cci  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,janu>y #cj1 #bjbe,mr4 
,crapo 7= himself1 ,mr4 ,b5net1 ,mr4    
,scott ( ,s\? ,c>ol9a1 & ,mr4 ,wyd57    
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,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 ! ,nancy  
,g>dn] ,sewell ,m$ic>e ,multi-,canc]    
,e>ly ,detection ,scre5+ ,cov]age ,act4 
#b4 ,m$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$--  
7#a7 9 subsection 7s77#b7-- 7,a7 by     
/rik+ ! semicolon at ! end ( subp>agraph
 7,,jj7 & ins]t+ 2 &2 &  7,b7 by add+ at
 ! end ! foll[+ new subp>agraph3  7,,kk7
 multi-canc] e>ly detection scre5+ te/s 
7z def9$ 9 subsection 7nnn772  2 &  7#b7
 by add+ at ! end ! foll[+ new          

subsection3  7nnn7 ,multi-,canc] e>ly   
detection scre5+ te/s  7#a7 ,9 g5]al ,! 
t]m multi-canc] e>ly detection scre5+   
te/ means a te/ furni%$ to an individual
 = ! concurr5t detection ( multiple     
canc] types across multiple organ sites 
on or aft] ,janu>y #a1 #bjbh1 t-- 7,a7  
is cle>$ "u section #eaj7k71 classifi$  
"u section #eac7;f77#b71 or approv$ "u  
section #eae ( ! ,f$]al ,food1 ,drug1 & 
,cosmetic ,act2  7,b7 is-- 7i7 a g5omic 
sequ5c+ blood or blood product te/ t    
includes ! analysis ( cell-free nucleic 
acids2 or  7ii7 a te/ bas$ on samples ( 
biological mat]ial t provides results   
comp>able to ^? obta9$ ) a te/ describ$ 
9 clause 7i71 z det]m9$ by ! ,secret>y2 
&  7,c7 ! ,secret>y det]m9es is-- 7i7   
reasonable & necess>y = ! prev5tion or  
e>ly detection ( an illness or          
disability2 &  7ii7 appropriate =       
individuals entitl$ to b5efits "u "p ,a 
or enroll$ "u "p ,b4  7#b7 ,,ncd process
 ,9 mak+ det]m9ations "u p>agraph       
7#a77;,c7 reg>d+ ! cov]age ( a new te/1 

! ,secret>y %all use ! process = mak+   
national cov]age det]m9ations 7z def9$ 9
 section #ahfi7;f77#a77;,b77 "u ?is     
title4  4  7b7 ,paym5t & /&>ds =        
multi-,canc] e>ly detection scre5+ te/s 
7#a7 ,9 g5]al ,section #ahcd ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #aciem7  
is am5d$ by add+ at ! end ! foll[+ new  
subsection3  7aa7 ,paym5t & /&>ds =     
multi-,canc] e>ly detection scre5+ te/s 
7#a7 ,paym5t am\nt ,! paym5t am\nt = a  
multi-canc] e>ly detection scre5+ te/ 7z
 def9$ 9 section #ahfa7nnn77 is-- 7,a7 )
 respect to su* a te/ furni%$ be=e      
,janu>y #a1 #bjca1 equal to ! paym5t    
am\nt 9 effect on ! date ( ! enactm5t ( 
?is subsection = a multi-t>get /ool     
scre5+ ,,dna te/ cov]$ pursuant to      
section #ahfa7pp77#a77;,d72 &  7,b7 )   
respect to su* a te/ furni%$ on or aft] 
,janu>y #a1 #bjca1 equal to ! less] (-- 
7i7 ! am\nt describ$ 9 subp>agraph 7,a72
 or  7ii7 ! paym5t am\nt det]m9$ = su*  
te/ "u section #ahcd;,a4  7#b7          
,limitations  7,a7 ,9 g5]al ,no paym5t  

may be made "u ?is "p = a multi-canc]   
e>ly detection scre5+ te/ furni%$ dur+ a
 ye> to an individual if-- 7i7 z (      
,janu>y #a ( su* ye>1 su* individual has
 atta9$ ! age specifi$ 9 subp>agraph    
7,b7 = su* ye>2 or  7ii7 su* a te/ 0    
furni%$ to ! individual dur+ ! previ\s  
#aa mon?s4  7,b7 ,age specifi$ ,=       
purposes ( subp>agraph 7,a77i71 ! age   
specifi$ 9 ?is subp>agraph is-- 7i7 =   
#bjbh1 #fh ye>s ( age2 &  7ii7 = a      
succe$+ ye>1 ! age specifi$ 9 ?is       
subp>agraph = ! prec$+ ye>1 increas$ by 
#a ye>4  7#c7 ,/&>ds foll[+ ,,usp/f rat+
 ,9 ! case ( a multi-canc] e>ly         
detection scre5+ te/ t is recomm5d$ ) a 
grade ( ,a or ,b by ! ,unit$ ,/ates     
,prev5tive ,s]vices ,task ,=ce1 beg9n+  
on ! date on :i* cov]age = su* te/ is   
provid$ pursuant to section             
#ahfa7;ddd77#a71 ! prec$+ provisions (  
?is subsection %all n apply4  4  7#b7   
,con=m+ am5dm5ts  7,a7 ,section #ahcc ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciel7 is am5d$-- 7i7 9 subsection     

7a7-- 7,i7 9 p>agraph 7#a77;,d77i77,i71 
by /rik+ section #ahcd7;d77#a7 & ins]t+ 
subsection 7d77#a7 or 7aa7 ( section    
#ahcd2 &  7,,ii7 9 p>agraph             
7#b77;,d77i77,i71 by /rik+ section      
#ahcd7;d77#a7 & ins]t+ subsection       
7d77#a7 or 7aa7 ( section #ahcd2 &  7ii7
 9 subsection 7h71 by /rik+ section     
#ahcd7;d77#a7 & ins]t+ subsections      
7d77#a7 & 7aa7 ( section #ahcd4  7,b7   
,section #ahfb7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciey7a77 is      
am5d$-- 7i7 9 p>agraph 7#a7-- 7,i7 9    
subp>agraph 7,o71 by /rik+ & at ! end2  
7,,ii7 9 subp>agraph 7,p71 by /rik+ !   
semicolon at ! end & ins]t+ 1 &2 &      
7,,iii7 by add+ at ! end ! foll[+ new   
subp>agraph3  7,q7 9 ! case (           
multi-canc] e>ly detection scre5+ te/s  
7z def9$ 9 section #ahfa7nnn771 :i* are 
n reasonable & necess>y = ! concurr5t   
detection ( multiple canc] types across 
multiple organ sites2  2 &  7ii7 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$-- 7#a7 9 !
 case ( an individual :o und]goes a     
multi-canc] e>ly detection scre5+ te/1  
to affect cov]age "u "p ,b ( title      
,,xviii ( ! ,social ,security ,act = o!r
 canc] scre5+ te/s cov]$ "u su* 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 "u su* "p = 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