I 
119TH CONGRESS 
1ST SESSION 
H. R. 842 
To amend title XVIII of the Social Security Act to provide for Medicare 
coverage of multi-cancer early detection screening tests. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 31, 2025 
Mr. ARRINGTON (for himself, Ms. SEWELL, Mr. HUDSON, Mr. RUIZ, Mrs. 
MILLER-MEEKS, and Ms. KELLY of Illinois) 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 amend title XVIII of the Social Security Act to provide 
for Medicare coverage of multi-cancer early detection 
screening tests. 
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 ‘‘Nancy Gardner Sewell 
Medicare Multi-Cancer Early Detection Screening Cov-
erage Act’’. 
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SEC. 2. MEDICARE COVERAGE OF MULTI-CANCER EARLY 
DETECTION SCREENING TESTS. 
(a) COVERAGE.—Section 1861 of the Social Security 
Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) by striking the semicolon at the end of 
subparagraph (JJ) and inserting ‘‘; and’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(KK) multi-cancer early detection screen-
ing tests (as defined in subsection (nnn));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(nnn) MULTI-CANCER EARLY DETECTION SCREEN-
ING TESTS.— 
‘‘(1) IN
GENERAL.—The term ‘multi-cancer 
early detection screening test’ means a test fur-
nished to an individual for the concurrent detection 
of multiple cancer types across multiple organ sites 
on or after January 1, 2028, that— 
‘‘(A) is cleared under section 510(k), clas-
sified under section 513(f)(2), or approved 
under section 515 of the Federal Food, Drug, 
and Cosmetic Act; 
‘‘(B) is— 
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‘‘(i) a genomic sequencing blood or 
blood product test that includes the anal-
ysis of cell-free nucleic acids; or 
‘‘(ii) a test based on samples of bio-
logical material that provides results com-
parable to those obtained with a test de-
scribed in clause (i), as determined by the 
Secretary; and 
‘‘(C) the Secretary determines is— 
‘‘(i) reasonable and necessary for the 
prevention or early detection of an illness 
or disability; and 
‘‘(ii) appropriate for individuals enti-
tled to benefits under part A or enrolled 
under part B. 
‘‘(2) NCD PROCESS.—In making determina-
tions under paragraph (1)(C) regarding the coverage 
of a new test, the Secretary shall use the process for 
making national coverage determinations (as defined 
in section 1869(f)(1)(B)) under this title.’’. 
(b) PAYMENT AND STANDARDS FOR MULTI-CANCER 
EARLY DETECTION SCREENING TESTS.— 
(1) IN GENERAL.—Section 1834 of the Social 
Security Act (42 U.S.C. 1395m) is amended by add-
ing at the end the following new subsection: 
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‘‘(aa) PAYMENT AND STANDARDS FOR MULTI-CAN-
CER EARLY DETECTION SCREENING TESTS.— 
‘‘(1) 
PAYMENT
AMOUNT.—The 
payment 
amount for a multi-cancer early detection screening 
test (as defined in section 1861(nnn)) is— 
‘‘(A) with respect to such a test furnished 
before January 1, 2031, equal to the payment 
amount in effect on the date of the enactment 
of this subsection for a multi-target stool 
screening DNA test covered pursuant to section 
1861(pp)(1)(D); and 
‘‘(B) with respect to such a test furnished 
on or after January 1, 2031, equal to the lesser 
of— 
‘‘(i) the amount described in subpara-
graph (A); or 
‘‘(ii) the payment amount determined 
for such test under section 1834A. 
‘‘(2) LIMITATIONS.— 
‘‘(A) IN GENERAL.—No payment may be 
made under this part for a multi-cancer early 
detection screening test furnished during a year 
to an individual if— 
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‘‘(i) as of January 1 of such year, 
such individual has attained the age speci-
fied in subparagraph (B) for such year; or 
‘‘(ii) such a test was furnished to the 
individual during the previous 11 months. 
‘‘(B) AGE
SPECIFIED.—For purposes of 
subparagraph (A)(i), the age specified in this 
subparagraph is— 
‘‘(i) for 2028, 68 years of age; and 
‘‘(ii) for a succeeding year, the age 
specified in this subparagraph for the pre-
ceding year, increased by 1 year. 
‘‘(3) STANDARDS
FOLLOWING
USPSTF
RAT-
ING.—In the case of a multi-cancer early detection 
screening test that is recommended with a grade of 
A or B by the United States Preventive Services 
Task Force, beginning on the date on which cov-
erage for such test is provided pursuant to section 
1861(ddd)(1), the preceding provisions of this sub-
section shall not apply.’’. 
(2) CONFORMING AMENDMENTS.— 
(A) Section 1833 of the Social Security 
Act (42 U.S.C. 1395l) is amended— 
(i) in subsection (a)— 
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(I) in paragraph (1)(D)(i)(I), by 
striking ‘‘section 1834(d)(1)’’ and in-
serting ‘‘subsection (d)(1) or (aa) of 
section 1834’’; and 
(II) in paragraph (2)(D)(i)(I), by 
striking ‘‘section 1834(d)(1)’’ and in-
serting ‘‘subsection (d)(1) or (aa) of 
section 1834’’; and 
(ii) in subsection (h), by striking ‘‘sec-
tion 1834(d)(1)’’ and inserting ‘‘sub-
sections (d)(1) and (aa) of section 1834’’. 
(B) Section 1862(a) of the Social Security 
Act (42 U.S.C. 1395y(a)) is amended— 
(i) in paragraph (1)— 
(I) in subparagraph (O), by 
striking ‘‘and’’ at the end; 
(II) in subparagraph (P), by 
striking the semicolon at the end and 
inserting ‘‘, and’’; and 
(III) by adding at the end the 
following new subparagraph: 
‘‘(Q) in the case of multi-cancer early de-
tection screening tests (as defined in section 
1861(nnn)), which are not reasonable and nec-
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essary for the concurrent detection of multiple 
cancer types across multiple organ sites;’’; and 
(ii) in paragraph (7), by striking ‘‘or 
(P)’’ and inserting ‘‘(P), or (Q)’’. 
(c) RULE OF CONSTRUCTION RELATING TO OTHER 
CANCER SCREENING TESTS.—Nothing in this section, in-
cluding the amendments made by this section, shall be 
construed— 
(1) in the case of an individual who undergoes 
a multi-cancer early detection screening test, to af-
fect coverage under part B of title XVIII of the So-
cial Security Act for other cancer screening tests 
covered under such title, such as screening tests for 
breast, cervical, colorectal, lung, or prostate cancer; 
or 
(2) in the case of an individual who undergoes 
another cancer screening test, to affect coverage 
under such part for a multi-cancer early detection 
screening test or the use of such a test as a diag-
nostic or confirmatory test for a result of the other 
cancer screening test. 
Æ 
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