,,ii  #aai? ,,congress  #b;d ,session   
,s4 #eeed  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #bd1         
#bjbf,ms4 ,slotk9 7= h]self & ,mrs4     
,britt7 introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to mod]nize & /r5g!n ,f$]al 
ef=ts to improve ov>ian canc] aw>5ess1  
h]$it>y canc] risk assessm5t1 access to 
g5etic c\nsel+ & te/+1 & access to      
specialty c>e1 & = o!r purposes4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,ov>ian ,canc] ,improv+ & ,mod]niz+     
,prev5tion1 ,access1 ,c>e1 & ,te/+ ,act 
or ! ,ov>ian ,canc] ,,impact ,act4  #b4 
,f9d+s ,congress f9ds ! foll[+3 7#a7    
,ov>ian canc] rema9s "o ( ! deadlie/    
gynecologic canc]s & is frequ5tly       
diagnos$ at an advanc$ /age4  7#b7 ,e>ly
 recognition ( symptoms1 access to      
g5etic c\nsel+ & te/+1 & timely ref]ral 
to specializ$ c>e c improve outcomes =  
individuals diagnos$ ) ov>ian canc]4    
7#c7 ,significant disp>ities p]si/ 9    

access to gynecologic oncology s]vices1 
g5etic c\nsel+1 h]$it>y canc] risk      
assessm5t1 & specialty c>e1 p>ticul>ly 9
 rural & m$ically und]s]v$ communities4 
7#d7 ,advances 9 g5etic & g5omic sci5ce 
pres5t significant opportunities to     
improve prev5tion1 e>ly detection1      
treatm5t selection1 & survivor%ip       
outcomes4  7#e7 ,h]$it>y canc]          
syndromes1 includ+ h]$it>y brea/ &      
ov>ian canc] syndrome & ,lyn* syndrome1 
contribute significantly to ov>ian canc]
 risk & may fir/ be id5tifi$ foll[+ a   
diagnosis ( endometrial canc]4  7#f7    
,evid5ce-bas$ g5etic c\nsel+ & te/+ c   
in=m treatm5t decisions1 guide prev5tive
 int]v5tions1 & id5tify at-risk family  
memb]s :o may b5efit f surveillance or  
risk-r$uc+ c>e4  7#g7 ,increas$ public  
education1 provid] aw>5ess1 & access to 
specialty c>e are ess5tial to improv+   
outcomes = individuals affect$ by ov>ian
 canc] & h]$it>y canc] syndromes4  #c4  
,reau?orization & improvem5t (          
,johanna's ,law ,section #cag,p7d7 ( !  

,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bdg;b-#ag7;d77 is am5d$--    
7#a7 9 p>agraph 7#a7-- 7,a7 9           
subp>agraph 7,a71 by ins]t+ 1 9         
coord9ation ) relevant programs ( !     
,heal? ,res\rces & ,s]vices             
,adm9i/ration & ! ,national ,canc]      
,in/itute1 aft] ,! ,secret>y2 &  7,b7 by
 add+ at ! end ! foll[+3  7,d7 ,enhanc$ 
outrea* & education ,activities "u !    
national campaign "u subp>agraph 7,a7   
%all include-- 7i7 develop+ & dissem9at+
 culturally & l+ui/ically appropriate   
public s]vice ann\ncem5ts & educational 
mat]ials direct$ t[>d populations at    
elevat$ risk bas$ on race1 e?nicity1    
g5etic pr$isposition1 or family hi/ory2 
7ii7 conduct+ t>get$ outrea* activities 
= populations exp]i5c+ elevat$ risk (   
ov>ian canc] or disp>ities 9 outcomes1  
includ+ populations ) h]$it>y canc]     
syndromes & populations resid+ 9 rural &
 m$ically und]s]v$ communities2  7iii7  
promot+ aw>5ess ( h]$it>y canc]         
syndromes associat$ ) ov>ian canc] risk1

 includ+ h]$it>y brea/ & ov>ian canc]   
syndrome & ,lyn* syndrome1 & !          
availability ( g5etic c\nsel+1 g5etic   
te/+1 & evid5ce-bas$ risk-r$uc+         
int]v5tions2  7iv7 dissem9at+ in=mation 
reg>d+ cov]age & b5efits relat+ to      
g5etic c\nsel+1 g5etic te/+1 &          
risk-r$uc+ int]v5tions available "u     
,f$]al & private heal? insurance        
programs2  7v7 develop+ & di/ribut+     
educational mat]ials = pati5ts & heal?  
c>e pr(essionals reg>d+ curr5t          
evid5ce-bas$ guidel9es relat+ to h]$it>y
 canc] risk assessm5t1 g5etic c\nsel+1  
g5etic te/+1 & ref]ral to specialty c>e2
 &  7vi7 develop+ & dissem9at+ in=mation
 = pati5ts & heal? c>e provid]s on      
evid5ce-bas$ ov>ian canc] risk-r$uction 
/rategies1 includ+ opportuni/ic         
salp+ectomy & ! circum/ances 9 :i* su*  
an int]v5tion may be appropriate4  2    
7#b7 by ins]t+ aft] p>agraph 7#d71 !    
foll[+3  7#e7 ,demon/ration projects    
7,a7 ,9 g5]al ,! ,secret>y %all aw>d    
grants to c>ry out demon/ration projects

 "u ?is subsection to te/ & evaluate    
outrea* /rategies relat+ to ov>ian canc]
 aw>5ess1 h]$it>y canc] risk assessm5t1 
g5etic c\nsel+1 g5etic te/+1 & access to
 specialty c>e4  7,b7 ,pref]5ce ,9 aw>d+
 grants "u ?is p>agraph1 ! ,secret>y    
%all give pref]5ce to applicants        
exp]i5c$ 9 s]v+ rural1 m$ically         
und]s]v$1 or high-risk populations4     
7,c7 ,eligible entities ,entities       
eligible to receive a grant "u ?is      
p>agraph %all include ,/ate1 local1 &   
,tribal public heal? dep>tm5ts1         
community heal? c5t]s1 rural hospitals1 
academic m$ical c5t]s1 nonpr(it         
organizations1 & o!r entities det]m9$   
appropriate by ! ,secret>y4  7,d7       
,reports ,n lat] ?an #c ye>s aft] ! date
 on :i* grants are aw>d$ "u ?is         
p>agraph1 & annually !reaft]1 !         
,secret>y %all submit to ,congress a    
report t evaluates outcomes ( projects  
c>ri$ out "u ?is p>agraph4 ,su* reports 
%all id5tify b>ri]s to c>e & conta9 be/ 
practices4  &  7#c7 by /rik+ p>agraph   

7#f7 & ins]t+ ! foll[+3  7#f7           
,au?orization ( appropriations ,= !     
purpose ( c>ry+ out ?is subsection1 !re 
is au?oriz$ to be appropriat$           
#bj1jjj1jjj = ea* ( fiscal ye>s #bjbg   
?r\gh #bjca4  4  #d4 ,rural access to   
ov>ian canc] c>e  7a7 ,rural heal? c>e  
s]vices outrea* grants ,section         
#ccj;,a7e7 ( ! ,public ,heal? ,s]vice   
,act 7#db ,u4,s4,c4 #bed;c7e77 is       
am5d$-- 7#a7 9 p>agraph 7#a71 by ins]t+ 
1 includ+ ) respect to ov>ian canc]     
prev5tion1 diagnosis1 treatm5t1         
survivor%ip s]vices1 h]$it>y canc] risk 
assessm5t1 g5etic c\nsel+1 & c>e        
coord9ation1 aft] deliv]y ( heal? c>e   
s]vices2 &  7#b7 9 p>agraph 7#b77;,a71  
by ins]t+ or ,tribal communities be=e ! 
semicolon4  7b7 ,exp&+ capacity = heal? 
outcomes ,section #ccj,n7b7 ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bed;c-#bj7;b77 is am5d$ by ins]t+      
ov>ian canc]1 aft] palliative c>e14  #e4
 ,/&>ds relat+ to b5efits = g5etic &    
g5omic te/+ =1 e>ly detection (1 &      

risk-r$uc+ int]v5tions ) respect to     
ov>ian canc]  7a7 ,9 g5]al ,"p ,a (     
title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg et seq47 is
 am5d$ by ins]t+ aft] section #bgbi !   
foll[+ new section3  #bgbi;,a4 ,/&>ds   
relat+ to b5efits = g5etic & g5omic te/+
 =1 e>ly detection (1 & risk-r$uc+      
int]v5tions ) respect to ov>ian canc]   
7a7 ,cov]age relat+ to b5efits = g5etic 
& g5omic te/+  7#a7 ,9 g5]al ,a gr\p    
heal? plan1 or a heal? insurance issu]  
(f]+ gr\p or individual heal? insurance 
cov]age1 %all provide cov]age to an     
enrollee-- 7,a7 :o-- 7i7 has a p]sonal  
hi/ory ( ov>ian canc]2  7ii7 has a      
p]sonal hi/ory ( endometrial canc] = :om
 g5etic c\nsel+ or g5etic te/+ is       
recomm5d$ "u evid5ce-bas$ cl9ical       
practice guidel9es develop$ by !        
,national ,compreh5sive ,canc] ,network1
 ! ,am]ican ,society ( ,cl9ical         
,oncology1 or ! ,society ( ,gynecologic 
,oncology2 or  7iii7 has a family hi/ory
 indicative ( h]$it>y ov>ian canc]1     

,lyn* syndrome1 or ano!r h]$it>y canc]  
syndrome associat$ ) increas$ ov>ian    
canc] risk2 &  7,b7 =-- 7i7 g5etic      
c\nsel+ by a c]tifi$ provid] 79 p]son or
 via teleheal?72  7ii7 multi-g5e panel  
te/+ = g]ml9e g5etic mutations us+      
next-g5]ation sequ5c+ or o!r comp>able  
advanc$ diagno/ic te/+ te*nologies1 z   
applicable2  7iii7 s+le syndrome1       
s+le-g5e mutation te/+1 or t>get$       
mutation te/+ if det]m9$ by ! att5d+    
heal? c>e provid] to be m appropriate2 &
  7iv7 tumor g5omic pr(il+ or biom>k]   
te/+ = somatic mutations us+            
next-g5]ation sequ5c+1 or o!r comp>able 
advanc$ diagno/ic te/+ te*nology1 z     
applicable4  7#b7 ,scope ( te/+ ,te/+   
requir$ "u ?is subsection %all include  
te/+ to detect-- 7,a7 g5etic mutations 9
 ,,brca#a & ,,brca#b g5es2  7,b7 g5etic 
mutations associat$ ) ,lyn* syndrome2   
7,c7 mismat* repair defici5cy1          
microsatellite in/ability1 & o!r        
biom>k]s recomm5d$ "u evid5ce-bas$      
cl9ical practice guidel9es =            

id5tification ( ,lyn* syndrome or o!r   
h]$it>y canc] syndromes associat$ )     
increas$ ov>ian canc] risk2  7,d7       
re>rangem5t analysis ( all cod+ exons   
associat$ ) ov>ian canc]2 &  7,e7       
additional mutations1 includ+ mutations 
9 ! ,,brip#a1 ,,rad#ea;,c1 & ,,rad#ea;,d
 g5es1 9 accordance ) evid5ce-bas$      
cl9ical practice guidel9es address+     
g5etic te/+1 scre5+1 & managem5t (      
individuals ) a p]sonal hi/ory ( ov>ian 
canc] or a family hi/ory indicat+ or    
suspici\s = increas$ ov>ian canc] risk  
develop$ by ! ,national ,compreh5sive   
,canc] ,network1 ! ,am]ican ,society (  
,cl9ical ,oncology1 ! ,society (        
,gynecologic ,oncology1 or ano!r        
nationally recogniz$ oncology           
pr(essional organization4  7#c7         
,application ( guidel9es ,9 adm9i/]+    
p>agraph 7#b7 9 ! case ( conflict+      
guidel9es develop$ by m ?an "o          
nationally recogniz$ oncology           
pr(essional organization1 ! lea/        
re/rictive ( su* guidel9es %all apply4  

7#d7 ,repeat or exp&$ te/+ ,a gr\p heal?
 plan or heal? insurance issu] %all     
provide cov]age ( repeat or exp&$ te/+  
if m$ically necess>y & appropriate1 z   
det]m9$ by ! treat+ heal? c>e provid]4  
7b7 ,cov]age = e>ly detection &         
risk-,r$uc+ int]v5tions ,a gr\p heal?   
plan1 & a heal? insurance issu] (f]+    
gr\p or individual heal? insurance      
cov]age1 %all provide cov]age =         
evid5ce-bas$ e>ly detection1 h]$it>y    
canc] risk managem5t1 risk-r$uc+        
surg]ies1 & o!r int]v5tions int5d$ to   
r$uce ! risk ( ov>ian canc] 9           
individuals id5tifi$ z be+ at elevat$   
h]$it>y risk :]e indicat$ "u nationally 
recogniz$ oncology pr(essional          
organization guidel9es4 ,cov]age "u ?is 
subsection %all be provid$ reg>dless (  
:e!r ! enrollee has a p]sonal hi/ory (  
ov>ian canc] or endometrial canc]4  7c7 
,rule ( con/ruction ,no?+ 9 ?is section 
%all be con/ru$ to require an enrollee  
to receive te/+1 e>ly detection1 or     
risk-r$uc+ int]v5tions describ$ 9 ?is   

section4  7d7 ,level & type (           
reimbursem5ts ,no?+ 9 ?is section %all  
be con/ru$ to prev5t a gr\p heal? plan  
or heal? insurance issu] f negotiat+ !  
level & type ( reimbursem5t ) a provid] 
= c>e provid$ 9 accordance ) ?is        
section4  7e7 ,provid] education &      
implem5tation ,! ,secret>y1 act+ ?r\gh !
 ,director ( ! ,c5t]s = ,disease        
,control & ,prev5tion & 9 consultation )
 ! ,adm9i/rator ( ! ,heal? ,res\rces &  
,s]vices ,adm9i/ration1 %all support    
activities to increase aw>5ess among    
heal? c>e pr(essionals reg>d+-- 7#a7    
evid5ce-bas$ guidel9es = g5etic c\nsel+ 
& g5etic te/+ 9 individuals diagnos$ )  
ov>ian canc] or endometrial canc]2  7#b7
 collection & assessm5t ( family canc]  
hi/ory2  7#c7 appropriate ref]ral       
pa?ways = g5etic c\nsel+ & specialty    
c>e2 &  7#d7 cov]age protections        
e/abli%$ "u ?is section4  7f7           
,evaluation ,! ,secret>y %all evaluate  
activities conduct$ "u ?is section1     
includ+-- 7#a7 provid+ = public aw>5ess 

( ov>ian canc] symptoms & h]$it>y canc] 
risk factors2  7#b7 provid+ provid]     
aw>5ess ( evid5ce-bas$ g5etic c\nsel+ & 
te/+ guidel9es2  7#c7 ! utilization (   
g5etic c\nsel+ & te/+ s]vices2  7#d7    
ensur+ access to s]vices 9 rural &      
m$ically und]s]v$ communities2 &  7#e7  
:e!r b>ri]s exi/ to ! implem5tation (   
?is section4  7g7 ,privacy protections  
,! ,secret>y %all ensure t ?is section  
is c>ri$ out 9 a mann] t complies ) all 
applicable ,f$]al & ,/ate privacy laws4 
4  7b7 ,application to gr&fa!r$ heal?   
plans ,section #abea7;a77#d77;,a7 ( !   
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjaa7;a77#d77;,a77
 is am5d$-- 7#a7 9 ! matt] prec$+ clause
 7i71 by /rik+ 7z add$ by ?is title72 & 
7#b7 by add+ at ! end ! foll[+3  7v7    
,section #bgbi;,a 7relat+ to /&>ds      
relat+ to b5efits = g5etic & g5omic te/+
 =1 e>ly detection (1 & risk-r$uc+      
int]v5tions ) respect to ov>ian canc]74 
4  7c7 ,effective date ,! am5dm5ts made 
by ?is section %all apply ) respect to  

plan ye>s beg9n+ on or aft] ! date t is 
#a ye> aft] ! date ( enactm5t ( ?is     
,act4  #f4 ,implem5tation & report+  7a7
 ,implem5tation plan ,n lat] ?an #ahj   
days aft] ! date ( enactm5t ( ?is ,act1 
! ,secret>y ( ,heal? & ,human ,s]vices  
%all submit to ,congress an             
implem5tation plan outl9+ timel9es1     
ag5cy responsibilities1 & p]=mance      
b5*m>ks ) respect to ! am5dm5ts made by 
?is ,act4  7b7 ,report ,n lat] ?an #c   
ye>s aft] ! date ( enactm5t ( ?is ,act1 
& e #c ye>s !reaft] ?r\gh fiscal ye>    
#bjcb1 ! ,secret>y ( ,heal? & ,human    
,s]vices %all submit to ,congress a     
report t describes-- 7#a7 implem5tation 
activities "u ! am5dm5ts made by ?is    
,act2  7#b7 ! utilization ( g5etic      
c\nsel+ & te/+ s]vices "u su* am5dm5ts2 
7#c7 ! utilization ( risk-r$uc+         
int]v5tions "u su* am5dm5ts2  7#d7      
progress made 9 improv+ access to ov>ian
 canc] c>e 9 rural & m$ically und]s]v$  
communities2 &  7#e7 recomm5dations =   
fur!r legislative or adm9i/rative       

action4