,,ii #aaith ,,congress #b;d ,session ,s4 #deff ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ai1 #bjbf,mr4 ,durbin 7for himself and ,ms4 ,hirono7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to require coverage under ,state plans under the ,medicaid program for annual lung cancer screening with no cost sharing for individuals for whom screening is recommended by ,u4,s4 ,preventive ,services ,task ,force guidelines1 to expand coverage under ,medicaid of counseling and pharmacotherapy for cessation of tobacco use1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,increasing ,access to ,lung ,cancer ,screening ,act4 #b4 ,medicaid coverage of annual lung cancer screening with no cost sharing for certain individuals 7a7 ,in general ,section #aije7;a77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#d77 is amended-- 7#a7 by striking and before 7,d72 7#b7 by striking and before 7,e72 7#c7 by striking and before 7,f72 and 7#d7 by inserting before the semicolon at the end the following3 2 and 7,g7 an annual lung cancer screening for individuals who are eligible under the ,state plan or under a waiver of such plan and for whom such screening is recommended under guidelines published by the ,united ,states ,preventive ,services ,task ,force 7provided that such guidelines do not decrease the recommended frequency of lung cancer screenings for such individuals or narrow the population recommended for lung cancer screening published by the ,united ,states ,preventive ,services ,task ,force on ,march #i1 #bjba71 without regard to prior authorization4 7b7 ,no cost sharing 7#a7 ,in general ,subsections 7a77#b7 and 7b77#b7 of section #aiaf of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo7 are each amended-- 7,a7 in subparagraph 7,i71 by striking or at the end2 7,b7 in subparagraph 7,j71 by striking 2 and and inserting 1 or at the end2 and 7,c7 by adding at the end the following new subparagraph3 7,k7 lung cancer screening for which payment may be made under the ,state plan or under a waiver of such plan pursuant section to #aije7;a77#d77;,g72 and 4 7#b7 ,application to alternative cost sharing ,section #aiaf;,a7b77#c77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is amended by adding at the end the following new clause3 7xv7 ,lung cancer screening for which payment may be made under the ,state plan or under a waiver of such plan pursuant to section #aije7;a77#d77;,g74 4 7c7 ,application to ,medicaid managed care organizations ,section #aicb7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#b7;b77 is amended by adding at the end the following new paragraph3 7#i7 ,lung cancer screening ,each contract with a medicaid managed care organization under section #aijc7m7 shall require the organization to provide coverage for lung cancer screening for which payment may be made under the ,state plan or under a waiver of such plan pursuant to section #aije7;a77#d77;,g7 without regard to prior authorization4 4 7d7 ,effective date 7#a7 ,in general ,subject to paragraph 7#b71 the amendments made by this section shall apply with respect to items and services furnished on or after ,january #a1 #bjbh4 7#b7 ,exception if ,state legislation required ,in the case of a ,state plan for medical assistance under title ,,xix of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirements imposed by the amendments made by this section1 the ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of the enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of such session shall be deemed to be a separate regular session of the ,state legislature4 #c4 ,expanding coverage under ,medicaid of counseling and pharmacotherapy for cessation of tobacco use to all ,medicaid individuals 7a7 ,in general ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7a77#d77;,d7-- 7,a7 by striking by pregnant women2 and 7,b7 by inserting without regard to prior authorization after 7as defined in subsection 7bb772 and 7#b7 in subsection 7bb7-- 7,a7 by striking by pregnant women each place it appears2 7,b7 in paragraph 7#a71 by striking tobacco use who and inserting tobacco use 7including the use of e-cigarettes or vape pens7 by individuals who2 and 7,c7 in paragraph 7#b77;,a71 by striking with respect to pregnant women4 7b7 ,conforming amendments 7#a7 ,section #aibg7;d77#b77;,f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7;d77#b77;,f77 is amended by striking 1 in the case of pregnant women4 7#b7 ,section #aiaf of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo71 as amended by section #b7;b77#a71 is further amended in each of subsections 7a77#b7 and 7b77#b7-- 7,a7 in subparagraph 7,b71 by striking 1 and counseling and pharmacotherapy for cessation of tobacco use by pregnant women 7as defined in section #aije7;bb77 and covered outpatient drugs 7as defined in subsection 7k77#b7 of section #aibg and including nonprescription drugs described in subsection 7d77#b7 of such section7 that are prescribed for purposes of promoting1 and when used to promote1 tobacco cessation by pregnant women in accordance with the ,guideline referred to in section #aije7;bb77#b77;,a72 7,b7 in subparagraph 7,j71 by striking or at the end2 7,c7 in subparagraph 7,k71 by striking 2 and at the end and inserting 1 or2 and 7,d7 by adding at the end the following new subparagraph3 7,l7 counseling and pharmacotherapy for cessation of tobacco use 7as defined in section #aije7;bb77 and covered outpatient drugs 7as defined in subsection 7k77#b7 of section #aibg and including nonprescription drugs described in subsection 7d77#b7 of such section7 that are prescribed for purposes of promoting1 and when used to promote1 tobacco cessation in accordance with the ,guideline referred to in section #aije7;bb77#b77;,a72 and 4 7#c7 ,section #aiaf;,a7b77#c77;,b7 of such ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b771 as amended by section #b7;b77#b71 is further amended-- 7,a7 in clause 7iii71 by striking 1 and counseling and pharmacotherapy for cessation of tobacco use by pregnant women 7as defined in section #aije7;bb772 and 7,b7 by adding at the end the following new clause3 7xvi7 ,counseling and pharmacotherapy for cessation of tobacco use 7as defined in section #aije7;bb774 4 7c7 ,application to ,medicaid managed care organizations ,section #aicb7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#b7;b771 as amended by section #b7;c71 is further amended by adding at the end the following new paragraph3 7#aj7 ,cessation of ,tobacco ,use ,each contract with a medicaid managed care organization under section #aijc7m7 shall require the organization to provide coverage for counseling and pharmacotherapy for cessation of tobacco use without regard to prior authorization4 4 7d7 ,effective date 7#a7 ,in general ,subject to paragraph 7#b71 the amendments made by this section shall apply with respect to items and services furnished on or after ,january #a1 #bjbh4 7#b7 ,exception if ,state legislation required ,in the case of a ,state plan for medical assistance under title ,,xix of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirements imposed by the amendments made by this section1 the ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of the enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of such session shall be deemed to be a separate regular session of the ,state legislature4 #d4 ,coverage under ,medicare and private health insurance of annual lung cancer screening without utilization management requirements 7a7 ,medicare 7#a7 ,in general ,section #ahcd of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7 is amended by adding at the end the following new subsection3 7bb7 ,special rule for annual lung cancer screening ,notwithstanding any other provision of this title1 in the case of an annual lung cancer screening for which benefits are provided under this part for any individual for whom such screening is recommended in accordance with guidelines issued by the ,secretary1 such benefits shall be provided without application of any prior authorization4 4 7#b7 ,application under ,medicare ,advantage ,section #aheb7;a77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bb7;a77#a77;,b77 is amended by adding at the end the following new clause3 7vii7 ,prohibition of application of certain requirements for annual lung cancer screening ,in the case of an annual lung cancer screening for which benefits are provided under part ,b for any individual for whom such screening is recommended in accordance with guidelines issued by the ,secretary for purposes of section #ahcd7;bb71 an ,,ma plan may not impose any prior authorization with respect to the coverage of such screening under such plan4 4 7#c7 ,effective date ,the amendments made by this subsection shall apply with respect to services furnished on or after ,january #a1 #bjbh4 7b7 ,individual and group health insurance markets 7#a7 ,in general ,section #bgac of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ac7 is amended by adding at the end the following new subsection3 7d7 ,prohibition of application of certain requirements for annual lung cancer screening ,a group health plan and a health insurance issuer offering group or individual health insurance coverage may not require any prior authorization with respect to the benefits under such plan or coverage for an annual lung cancer screening for any individual for whom such screening is recommended by the ,united ,states ,preventive ,services ,task ,force4 4 7#b7 ,effective date ,the amendments made by this subsection shall apply with respect to plan years beginning on or after ,january #a1 #bjbh4 #e4 ,lung cancer screening education and outreach 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary71 in consultation with patient and lung cancer advocacy groups1 shall conduct an education and outreach campaign for purposes of informing individuals and health care providers of-- 7#a7 the importance of lung cancer screenings2 and 7#b7 the categories of individuals who should receive such screenings4 7b7 ,manner of outreach ,the ,secretary may carry out the campaign described in subsection 7a7 directly1 by contract1 through the issuance of grants1 or otherwise4 ,in carrying out such campaign1 the ,secretary shall ensure that the campaign is targeted to reach individuals at high risk of lung cancer4 7c7 ,funding ,there are authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbh through #bjcb for purposes of carrying out this section4 #f4 ,report ,not later than #a year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall conduct a study and submit to ,congress a report on the demographics of individuals diagnosed with lung cancer and individuals screened for such cancer4 ,such report shall identify-- 7#a7 any segments of the population diagnosed with lung cancer but not captured in current screening eligibility guidelines 7such as firefighters1 veterans1 and women under #ej years of age72 and 7#b7 recommendations for how the ,federal ,government can improve screening for such cancer among such segments4