I 

118TH CONGRESS 

1ST SESSION H. R. 5864 

To amend title XIX of the Social Security Act to provide for coverage 

under the Medicaid program of non-invasive prenatal genetic screening. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 2, 2023 

Mr. FITZPATRICK (for himself and Ms. CLARKE of New York) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to provide 

for coverage under the Medicaid program of non-invasive 

prenatal genetic screening. 

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 ‘‘Expanded Genetic 

5 Screening Act’’. 

6 SEC. 2. MEDICAID COVERAGE OF NON-INVASIVE PRENATAL 

7 GENETIC SCREENING. 

8 (a) IN GENERAL.—Section 1905 of the Social Secu9 rity Act (42 U.S.C. 1396d) is amended— 

10 (1) in subsection (a)(3)— 


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1 (A) in subparagraph (A), by striking at the 

2 end ‘‘and’’; 

3 (B) in subparagraph (B), by inserting 

4 ‘‘and’’ after the semicolon; and 

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

6 subparagraph: 

7 ‘‘(C) non-invasive prenatal genetic screen8 ing for pregnant women of all age groups (pro9 vided in a facility, a home, or other setting), 

10 subject to the informed consent requirement de11 scribed in subsection (jj);’’; and 

12 (2) by adding at the end the following new sub13 section: 

14 ‘‘(jj) INFORMED CONSENT REQUIREMENT FOR NON15 INVASIVE PRENATAL GENETIC SCREENING.— 

16 ‘‘(1) IN GENERAL.—For purposes of subsection 

17 (a)(3)(C), the informed consent requirement de18 scribed in this subsection for non-invasive prenatal 

19 genetic screening furnished to a pregnant woman is 

20 that, prior to furnishing the screening to the woman, 

21 the provider of the screening gives the woman a full 

22 disclosure that includes, at a minimum, the following 

23 information: 

24 ‘‘(A) The limitations of the screening plat25 form for any genetic screen or test with the 


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1 goal to identify risk or diagnose a genetic condi2 tion. 

3 ‘‘(B) Any potential interferences that may 

4 affect the screening’s performance. 

5 ‘‘(C) Information about predictive values 

6 used by the screening based on appropriate 

7 matching population and inherent risk factors 

8 based on age, family history, and other 

9 aneuploidy risk factors (such as ultrasound ab10 normalities). 

11 ‘‘(D) The need for follow-up diagnostic 

12 testing to confirm true positive results before 

13 decisions are made about irrevocable clinical 

14 intervention. 

15 ‘‘(2) NO MEDICAL ASSISTANCE AVAILABLE FOR

16 SCREENINGS PROVIDED WITHOUT CONSENT.—No 

17 payment may be made under section 1903(a) with 

18 respect to a non-invasive prenatal genetic screening 

19 that is furnished to a pregnant woman without 

20 meeting the requirement described in paragraph 

21 (1).’’. 

22 (b) CONFORMING AMENDMENT.—Section 1903(i) of 

23 the Social Security Act (42 U.S.C. 1396b(i)) is amend24 ed— 

25 (1) in paragraph (26), by striking ‘‘; or’’; 


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1 (2) in paragraph (27), by striking the period 

2 and inserting ‘‘; or’’; and 

3 (3) by inserting after paragraph (27) the fol4 lowing new paragraph: 

5 ‘‘(28) with respect to amounts expended for 

6 non-invasive prenatal genetic screening services fur7 nished to a pregnant woman, unless the informed 

8 consent requirement of section 1905(jj) is met.’’. 

Æ 


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