I 

118TH CONGRESS 

1ST SESSION H. R. 1526 

To amend title XVIII of the Social Security Act to provide hereditary cancer 

genetic testing for individuals with a history of a hereditary cancer 

gene mutation in a blood relative or a personal or ancestral history 

suspicious for hereditary cancer, and to provide coverage of certain 

cancer screenings or preventive surgeries that would reduce the risk 

for individuals with a germline (inherited) mutation associated with a 

high risk of developing a preventable cancer. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 9, 2023 

Ms. WASSERMAN SCHULTZ (for herself, Mrs. MILLER-MEEKS, Ms. SLOTKIN, 

Mr. BUCSHON, Mr. KILMER, Mr. TRONE, Mr. TONKO, Ms. MOORE of 

Wisconsin, Ms. BUSH, Mr. COHEN, Mr. LYNCH, Mr. BACON, Mr. SOTO, 

Ms. CLARKE of New York, Mr. RUPPERSBERGER, Mr. MFUME, Mr. CARSON, Ms. CASTOR of Florida, Mr. GOTTHEIMER, Mr. FITZPATRICK, and 

Ms. SCHAKOWSKY) introduced the following bill; which was referred to 

the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined 

by the Speaker, in each case for consideration of such provisions as fall 

within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to provide 

hereditary cancer genetic testing for individuals with a 

history of a hereditary cancer gene mutation in a blood 

relative or a personal or ancestral history suspicious for 

hereditary cancer, and to provide coverage of certain 

cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) 


kjohnson on DSK79L0C42PROD with BILLS
2 

•HR 1526 IH

mutation associated with a high risk of developing a 

preventable cancer. 

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 ‘‘Reducing Hereditary 

5 Cancer Act’’. 

6 SEC. 2. HEREDITARY CANCER GENETIC TESTING OF INDI7 VIDUALS WITH A FAMILY HISTORY OF A HE8 REDITARY CANCER GENE MUTATION OR PER9 SONAL OR FAMILY HISTORY SUSPICIOUS FOR 

10 HEREDITARY CANCER. 

11 (a) COVERAGE.—Section 1861 of the Social Security 

12 Act (42 U.S.C. 1395x) is amended— 

13 (1) in subsection (s)(2)— 

14 (A) by striking ‘‘and’’ at the end of sub15 paragraph (II); 

16 (B) by striking the period and inserting ‘‘; 

17 and’’ at the end of subparagraph (JJ); and 

18 (C) by inserting after subparagraph (JJ) 

19 the following new subparagraph: 

20 ‘‘(KK) in the case of an individual with a 

21 personal or family history of a hereditary can22 cer gene mutation or a personal or family his23 tory suspicious for hereditary cancer, germline 

24 mutation testing.’’; and 


kjohnson on DSK79L0C42PROD with BILLS
3 

•HR 1526 IH

1 (2) by adding at the end the following new sub2 section: 

3 ‘‘(nnn) GERMLINE MUTATION TESTING.—The term 

4 ‘germline mutation testing’ means genetic testing for 

5 germline mutations that is in accordance with evidence6 based, clinical practice guidelines specifically addressing 

7 genetic testing, screening, and management of individuals 

8 with inherited mutations associated with increased cancer 

9 risk that— 

10 ‘‘(1) have been developed by a nationally recog11 nized oncology professional organization, including 

12 the National Comprehensive Cancer Network, the 

13 American Society of Clinical Oncology, the Society 

14 of Gynecologic Oncology, or any other oncology pro15 fessional organization specified by a medicare ad16 ministrative contractor with a contract under section 

17 1874A; and 

18 ‘‘(2) in the case of conflicting guidelines devel19 oped by more than one nationally recognized oncol20 ogy professional organization, the least restrictive of 

21 such guidelines, as determined by such a medicare 

22 administrative contractor.’’. 

23 (b) FREQUENCY.—Section 1862(a)(1) of the Social 

24 Security Act (42 U.S.C. 1395y(a)(1)) is amended— 


kjohnson on DSK79L0C42PROD with BILLS
4 

•HR 1526 IH

1 (1) by striking ‘‘and’’ at the end of subpara2 graph (O); 

3 (2) by adding ‘‘and’’ at the end of subpara4 graph (P); and 

5 (3) by adding at the end the following new sub6 paragraph: 

7 ‘‘(Q) in the case of germline mutation test8 ing as defined in section 1861(lll), which is per9 formed more than once with respect to an indi10 vidual described in such section;’’. 

11 (c) EFFECTIVE DATE.—The amendments made by 

12 this section shall apply to testing furnished on or after 

13 the date of the enactment of this Act. 

14 SEC. 3. COVERAGE OF CERTAIN PREVENTIVE SURGERIES. 

15 (a) IN GENERAL.—Section 1862 of the Social Secu16 rity Act (42 U.S.C. 1395y) is amended by adding at the 

17 end the following new subsection: 

18 ‘‘(p) COVERAGE OF CERTAIN RISK-REDUCING SUR19 GERIES.—In the case of an individual described in section 

20 1861(s)(2)(II) for whom, based on evidence-based, clinical 

21 practice guidelines described in section 1861(lll), surgery 

22 would reduce the risk of developing cancer, such risk-re23 ducing surgery shall be considered reasonable and nec24 essary for treatment of illness under subsection 

25 (a)(1)(A).’’. 


kjohnson on DSK79L0C42PROD with BILLS
5 

•HR 1526 IH

1 (b) EFFECTIVE DATE.—The amendment made by 

2 subsection (a) shall apply to items and services furnished 

3 on or after the date of the enactment of this Act. 

4 SEC. 4. COVERAGE OF EVIDENCE-BASED SCREENINGS FOR 

5 INDIVIDUALS WITH A HEREDITARY CANCER 

6 GENE MUTATION. 

7 (a) IN GENERAL.—Section 1862 of the Social Secu8 rity Act (42 U.S.C. 1395y), as amended by section 3, is 

9 amended by adding at the end the following new sub10 section: 

11 ‘‘(q) COVERAGE OF EVIDENCE-BASED SCREENINGS

12 FOR INDIVIDUALS WITH A HEREDITARY CANCER GENE

13 MUTATION.—In the case of an individual who is deter14 mined pursuant to genetic testing to have a hereditary 

15 cancer (germline) gene mutation, the Secretary shall in16 crease any frequency limitations (or other limitations on 

17 coverage otherwise applicable under this title) for any evi18 dence-based screenings furnished to such individual, to be 

19 in compliance with evidence-based, clinical practice guide20 lines described in section 1861(lll), or as determined ap21 propriate by the Secretary, but not less frequently than 

22 on an annual basis. For the purposes of this subsection, 

23 evidence-based screenings shall include screening mam24 mography, breast screening MRI, colonoscopy, PSA test25 ing, and any additional evidence-based screening modaliVerDate Sep 11 2014 02:03 Mar 23, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1526.IH H1526

kjohnson on DSK79L0C42PROD with BILLS
6 

•HR 1526 IH

1 ties appropriate for high-risk individuals as recommended 

2 by such guidelines.’’. 

3 (b) CONFORMING AMENDMENT FOR SCREENING

4 MAMMOGRAPHY.—Section 1834(c)(2)(A) of the Social Se5 curity Act (42 U.S.C. 1395m(c)(2)(A)) is amended, in the 

6 matter preceding clause (i), by striking ‘‘subparagraph 

7 (B)’’ and inserting ‘‘subparagraph (B) and section 

8 1862(q)’’. 

9 (c) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to items and services furnished on 

11 or after the date of the enactment of this Act. 

Æ 


kjohnson on DSK79L0C42PROD with BILLS