II 

118TH CONGRESS 

1ST SESSION S. 642 

To facilitate the development of treatments for cancers, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 2, 2023 

Ms. KLOBUCHAR (for herself and Mr. WICKER) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To facilitate the development of treatments for cancers, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Finn Sawyer Access 

5 to Cancer Testing Act’’. 

6 SEC. 2. COVERAGE OF CANCER DIAGNOSTIC AND LABORA7 TORY TESTS. 

8 (a) MEDICARE.— 

9 (1) COVERAGE.—Section 1861 of the Social Se10 curity Act (42 U.S.C. 1395x) is amended— 


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1 (A) in subsection (s)(2)— 

2 (i) in subparagraph (II), by striking 

3 ‘‘and’’ at the end; 

4 (ii) in subparagraph (JJ), by adding 

5 ‘‘and’’ at the end; and 

6 (iii) by adding at the end the fol7 lowing new subparagraph: 

8 ‘‘(KK) cancer diagnostic and laboratory tests 

9 (as defined in subsection (nnn)) furnished on or 

10 after the date that is 6 months after the date of the 

11 enactment of this subparagraph.’’; and 

12 (B) by adding at the end the following new 

13 subsection: 

14 ‘‘(nnn) CANCER DIAGNOSTIC AND LABORATORY

15 TESTS.— 

16 ‘‘(1) IN GENERAL.—The term ‘cancer diag17 nostic and laboratory tests’ means— 

18 ‘‘(A) microarray analysis, DNA sequenc19 ing, RNA sequencing, whole-exome sequencing, 

20 and other forms of next-generation sequencing 

21 furnished and reported by a clinical laboratory 

22 (as defined in section 353(a) of the Public 

23 Health Service Act); and 


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1 ‘‘(B) explanation and interpretation of any 

2 analysis or sequencing described in subpara3 graph (A); 

4 furnished to an individual diagnosed with cancer. 

5 ‘‘(2) FREQUENCY.—When an individual test as 

6 described in paragraph (1) reports out the same ge7 netic content, it may only be furnished with respect 

8 to an individual diagnosed with a cancer— 

9 ‘‘(A) once upon the diagnosis of such can10 cer; 

11 ‘‘(B) once upon any recurrence of such 

12 cancer; and 

13 ‘‘(C) as necessary for purposes of planning 

14 treatment or monitoring the progression of such 

15 cancer or the response of such cancer to treat16 ment.’’. 

17 (2) PAYMENT.—Section 1833 of the Social Se18 curity Act (42 U.S.C. 1395l) is amended— 

19 (A) in subsection (a)(1)— 

20 (i) by striking ‘‘and’’ before ‘‘(HH)’’; 

21 and 

22 (ii) by inserting the following before 

23 the semicolon: ‘‘, and (II) with respect to 

24 cancer diagnostic and laboratory tests (as 

25 defined in section 1861(nnn)), the amount 


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1 paid shall be an amount equal to 80 per2 cent (or 100 percent, in the case of such 

3 tests for which payment is made on an as4 signment-related basis) of the lesser of the 

5 actual charge for the test or the amount 

6 that would have been determined for such 

7 test under section 1834A had such test 

8 been a clinical diagnostic laboratory test;’’; 

9 and 

10 (B) in subsection (b)— 

11 (i) by striking ‘‘, and (13)’’ and in12 serting ‘‘(13)’’; and 

13 (ii) by striking ‘‘1861(n).’’ and insert14 ing ‘‘section 1861(n), and (14) such de15 ductible shall not apply with respect to 

16 cancer diagnostic and laboratory tests (as 

17 defined in section 1861(nnn))’’. 

18 (3) EXCLUSION MODIFICATION.—Section 

19 1862(a)(1) of the Social Security Act (42 U.S.C. 

20 1395y(a)(1)) is amended— 

21 (A) in subparagraph (O), by striking 

22 ‘‘and’’ at the end; 

23 (B) in subparagraph (P), by striking the 

24 semicolon and inserting ‘‘, and’’; and 


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1 (C) by adding at the end the following new 

2 subparagraph: 

3 ‘‘(Q) in the case of cancer diagnostic and lab4 oratory tests (as defined in section 1861(nnn)), 

5 which are performed more frequently than is covered 

6 under such section;’’. 

7 (b) MEDICAID.— 

8 (1) INCLUSION AS MEDICAL ASSISTANCE.—Sec9 tion 1905(a) of the Social Security Act (42 U.S.C. 

10 1396d(a)) is amended— 

11 (A) in paragraph (30), by striking ‘‘and’’ 

12 at the end; 

13 (B) by redesignating paragraph (31) as 

14 paragraph (32); and 

15 (C) by inserting after paragraph (30) the 

16 following new paragraph: 

17 ‘‘(31) cancer diagnostic and laboratory tests (as 

18 defined in section 1861(nnn)); and’’. 

19 (2) MANDATORY COVERAGE.—Section 

20 1902(a)(10)(A) of such Act is amended, in the mat21 ter preceding clause (i), by striking ‘‘and (30)’’ and 

22 inserting ‘‘(30), and (31)’’. 

23 (3) INCLUSION IN BENCHMARK COVERAGE.— 

24 Section 1937(b)(5) of such Act is amended by in25 serting before the period at the end the following: ‘‘, 


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1 and beginning January 1, 2025, coverage of cancer 

2 diagnostic and laboratory tests (as defined in section 

3 1861(nnn))’’. 

4 (4) CONFORMING AMENDMENTS.—Title XIX of 

5 the Social Security Act (42 U.S.C. 1396 et seq.) is 

6 amended— 

7 (A) in section 1902(nn)(3), by striking 

8 ‘‘paragraph (30) of section 1905(a)’’ and in9 serting ‘‘the last numbered paragraph of the 

10 first sentence of section 1905(a)’’; and 

11 (B) in section 1905(a), in the 4th sentence 

12 in the flush matter following the last numbered 

13 paragraph of the first sentence of such section, 

14 by striking ‘‘paragraph (30)’’ and inserting 

15 ‘‘the last numbered paragraph’’. 

16 (5) EFFECTIVE DATE.— 

17 (A) IN GENERAL.—The amendments made 

18 by this section shall apply with respect to items 

19 and services furnished on or after January 1, 

20 2025. 

21 (B) EXEMPTION FOR STATE LEGISLA22 TION.—In the case of a State plan under title 

23 XIX of the Social Security Act (42 U.S.C. 1396 

24 et seq.), or waiver of such plan, that the Sec25 retary of Health and Human Services deterVerDate Sep 11 2014 04:12 Mar 15, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S642.IS S642

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1 mines requires State legislation in order for the 

2 respective plan to meet any requirement im3 posed by amendments made by this section, the 

4 respective plan shall not be regarded as failing 

5 to comply with the requirements of such title 

6 solely on the basis of its failure to meet such 

7 an additional requirement before the first day 

8 of the first calendar quarter beginning after the 

9 close of the first regular session of the State 

10 legislature that begins after the date of the en11 actment of this Act. For purposes of the pre12 vious sentence, in the case of a State that has 

13 a 2-year legislative session, each year of the ses14 sion shall be considered to be a separate regular 

15 session of the State legislature. 

16 (c) CHIP.—Section 2103(c) of the Social Security 

17 Act (42 U.S.C. 1397cc(c)), as amended by section 

18 11405(b)(1) of Public Law 117–169, is amended by add19 ing at the end the following new paragraph: 

20 ‘‘(13) COVERAGE OF CANCER DIAGNOSTIC AND

21 LABORATORY TESTS.—Regardless of the type of cov22 erage elected by a State under subsection (a), begin23 ning January 1, 2025, child health assistance pro24 vided under such coverage for targeted low-income 

25 children and, in the case that the State elects to proVerDate Sep 11 2014 04:12 Mar 15, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S642.IS S642

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1 vide pregnancy-related assistance under such cov2 erage pursuant to section 2112, such pregnancy-re3 lated assistance for targeted low-income pregnant 

4 women (as defined in section 2112(d)), shall include 

5 coverage of cancer diagnostic and laboratory tests 

6 (as defined in section 1861(nnn)).’’. 

7 SEC. 3. EDUCATION AND AWARENESS PROGRAM ON 

8 GENOMIC TESTING. 

9 (a) IN GENERAL.—The Secretary of Health and 

10 Human Services, in coordination with the Director of the 

11 National Human Genome Research Institute, shall carry 

12 out an education and awareness program for physicians 

13 and the general public on what genomic testing is, how 

14 can be used, and the role of genetic counselors. 

15 (b) CANCER AND MOLECULAR DIAGNOSTICS.—The 

16 education and awareness program under subsection (a) 

17 shall encourage the inclusion in graduate medical edu18 cation and continuing medical education (including for 

19 specialty oncology services) of education and training on 

20 the importance of molecular diagnostics at diagnosis and 

21 reoccurrence of cancer to detect mutations. 

Æ 


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