I 
118TH CONGRESS 
1ST SESSION H. R. 1780 
To facilitate the development of treatments for cancer, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 24, 2023 
Mr. BILIRAKIS (for himself and Ms. MATSUI) 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 subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To facilitate the development of treatments for cancer, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Finn Sawyer Access 
to Cancer Testing Act’’. 
SEC. 2. COVERAGE OF CANCER DIAGNOSTIC AND LABORA-
TORY TESTS. 
(a) MEDICARE.— 
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(1) COVERAGE.—Section 1861 of the Social Se-
curity Act (42 U.S.C. 1395x) is amended— 
(A) in subsection (s)(2)— 
(i) in subparagraph (JJ), by adding 
‘‘and’’ at the end; and 
(ii) by adding at the end the following 
new subparagraph: 
‘‘(KK) cancer diagnostic and laboratory tests 
(as defined in subsection (nnn)) furnished on or 
after the date that is 6 months after the date of the 
enactment of this subparagraph.’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(nnn) CANCER
DIAGNOSTIC
AND
LABORATORY 
TESTS.— 
‘‘(1) IN
GENERAL.—The term ‘cancer diag-
nostic and laboratory tests’ means— 
‘‘(A) microarray analysis, DNA sequenc-
ing, RNA sequencing, whole-exome sequencing, 
and other forms of next-generation sequencing 
furnished and reported by a clinical laboratory 
(as defined in section 353(a) of the Public 
Health Service Act); and 
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‘‘(B) explanation and interpretation of any 
analysis or sequencing described in subpara-
graph (A); 
furnished to an individual diagnosed with cancer. 
‘‘(2) FREQUENCY.—When an individual test as 
described in paragraph (1) reports out the same ge-
netic content, it may only be furnished with respect 
to an individual diagnosed with a cancer— 
‘‘(A) once upon the diagnosis of such can-
cer; 
‘‘(B) once upon any recurrence of such 
cancer; and 
‘‘(C) as necessary for purposes of planning 
treatment or monitoring the progression of such 
cancer or the response of such cancer to treat-
ment.’’. 
(2) PAYMENT.—Section 1833 of the Social Se-
curity Act (42 U.S.C. 1395l) is amended— 
(A) in subsection (a)(1)— 
(i) by striking ‘‘and’’ before ‘‘(HH)’’; 
and 
(ii) by inserting the following before 
the semicolon: ‘‘, and (II) with respect to 
cancer diagnostic and laboratory tests (as 
defined in section 1861(nnn)), the amount 
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paid shall be an amount equal to 80 per-
cent (or 100 percent, in the case of such 
tests for which payment is made on an as-
signment-related basis) of the lesser of the 
actual charge for the test or the amount 
that would have been determined for such 
test under section 1834A had such test 
been a clinical diagnostic laboratory test;’’; 
and 
(B) in subsection (b)— 
(i) by striking ‘‘, and (13)’’ and in-
serting ‘‘(13)’’; and 
(ii) by striking ‘‘1861(n).’’ and insert-
ing ‘‘section 1861(n), and (14) such de-
ductible shall not apply with respect to 
cancer diagnostic and laboratory tests (as 
defined in section 1861(nnn))’’. 
(3) 
EXCLUSION
MODIFICATION.—Section 
1862(a)(1) of the Social Security Act (42 U.S.C. 
1395y(a)(1)) is amended— 
(A) in subparagraph (O), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (P), by striking the 
semicolon and inserting ‘‘, and’’; and 
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(C) by adding at the end the following new 
subparagraph: 
‘‘(Q) in the case of cancer diagnostic and lab-
oratory tests (as defined in section 1861(nnn)), 
which are performed more frequently than is covered 
under such section;’’. 
(b) MEDICAID.— 
(1) INCLUSION AS MEDICAL ASSISTANCE.—Sec-
tion 1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended— 
(A) in paragraph (30), by striking ‘‘and’’ 
at the end; 
(B) by redesignating paragraph (31) as 
paragraph (32); and 
(C) by inserting after paragraph (30) the 
following new paragraph: 
‘‘(31) cancer diagnostic and laboratory tests (as 
defined in section 1861(nnn)); and’’. 
(2) 
MANDATORY
COVERAGE.—Section 
1902(a)(10)(A) of such Act is amended, in the mat-
ter preceding clause (i), by striking ‘‘and (30)’’ and 
inserting ‘‘(30), and (31)’’. 
(3) INCLUSION
IN
BENCHMARK
COVERAGE.— 
Section 1937(b)(5) of such Act is amended by in-
serting before the period at the end the following: ‘‘, 
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and beginning January 1, 2025, coverage of cancer 
diagnostic and laboratory tests (as defined in section 
1861(nnn))’’. 
(4) CONFORMING AMENDMENTS.—Title XIX of 
the Social Security Act (42 U.S.C. 1396 et seq.) is 
amended— 
(A) in section 1902(nn)(3), by striking 
‘‘paragraph (31) of section 1905(a)’’ and in-
serting ‘‘paragraph (32) of section 1905(a)’’; 
and 
(B) in section 1905(a), in the 4th sentence 
in the flush matter following the last numbered 
paragraph of the first sentence of such section, 
by striking ‘‘paragraph (30)’’ and inserting 
‘‘paragraph (32)’’. 
(5) EFFECTIVE DATE.— 
(A) IN GENERAL.—The amendments made 
by this section shall apply with respect to items 
and services furnished on or after January 1, 
2025. 
(B) EXEMPTION
FOR
STATE
LEGISLA-
TION.—In the case of a State plan under title 
XIX of the Social Security Act (42 U.S.C. 1396 
et seq.), or waiver of such plan, that the Sec-
retary of Health and Human Services deter-
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mines requires State legislation in order for the 
respective plan to meet any requirement im-
posed by amendments made by this section, the 
respective 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 
an additional requirement 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 en-
actment of this Act. For purposes of the pre-
vious sentence, in the case of a State that has 
a 2-year legislative session, each year of the ses-
sion shall be considered to be a separate regular 
session of the State legislature. 
(c) CHIP.—Section 2103(c) of the Social Security 
Act (42 U.S.C. 1397cc(c)), as amended by section 
11405(b)(1) of Public Law 117–169, is amended by add-
ing at the end the following new paragraph: 
‘‘(13) COVERAGE OF CANCER DIAGNOSTIC AND 
LABORATORY TESTS.—Regardless of the type of cov-
erage elected by a State under subsection (a), begin-
ning January 1, 2025, child health assistance pro-
vided under such coverage for targeted low-income 
children and, in the case that the State elects to pro-
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vide pregnancy-related assistance under such cov-
erage pursuant to section 2112, such pregnancy-re-
lated assistance for targeted low-income pregnant 
women (as defined in section 2112(d)), shall include 
coverage of cancer diagnostic and laboratory tests 
(as defined in section 1861(nnn)).’’. 
SEC. 
3. 
EDUCATION 
AND 
AWARENESS 
PROGRAM 
ON 
GENOMIC TESTING. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, in coordination with the Director of the 
National Human Genome Research Institute, shall carry 
out an education and awareness program for physicians 
and the general public on what genomic testing is, how 
can be used, and the role of genetic counselors. 
(b) CANCER AND MOLECULAR DIAGNOSTICS.—The 
education and awareness program under subsection (a) 
shall encourage the inclusion in graduate medical edu-
cation and continuing medical education (including for 
specialty oncology services) of education and training on 
the importance of molecular diagnostics at diagnosis and 
reoccurrence of cancer to detect mutations. 
Æ 
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