I 
118TH CONGRESS 
1ST SESSION H. R. 2407 
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 
MARCH 30, 2023 
Mr. ARRINGTON (for himself, Ms. SEWELL, Mr. HUDSON, and Mr. RUIZ) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion 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’’. 
SEC. 2. FINDINGS; PURPOSE. 
(a) FINDINGS.—Congress finds the following: 
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(1) Detecting cancer early, before it has spread 
throughout the body, saves lives. Cancers detected 
when still localized can be treated more effectively 
and have a 4 times greater survival rate compared 
to cancers found after metastasis has occurred. Ex-
isting Medicare-covered early detection tests, such as 
mammograms and colonoscopies, have led to a sub-
stantial reduction in age-adjusted mortality. 
(2) Diagnosing and treating cancer earlier often 
results in less invasive treatments for patients, 
which are also less expensive. According to peer re-
viewed literature, treatment of early stage cancer is 
half the cost of metastatic cancer. 
(3) Driving national strategies to broadly detect 
cancer earlier will help reduce pervasive health dis-
parities since racial, ethnic, and geographic groups 
experience later stages of diagnosis, along with high-
er cancer incidence and mortality. 
(4) The benefits of early cancer detection to 
Medicare beneficiaries have been limited to five can-
cers. According to the National Cancer Institute’s 
Surveillance, Epidemiology, and End Results pro-
gram, 71 percent of the 600,000 cancer deaths each 
year are from types of cancer without a Medicare- 
covered early detection test. 
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(5) Age is the leading risk factor for cancer, 
placing Medicare beneficiaries at elevated risk. 
About 1,000,000 Medicare beneficiaries will be diag-
nosed with cancer this year, as the median age for 
cancer diagnosis is 66 years of age. 
(6) Several innovative private and academic ef-
forts are engaged in research, including advanced 
clinical trials to develop multi-cancer early detection 
blood-based tests. Published data indicate that these 
tests can screen for many cancers at the same time, 
including rare cancers, with one example currently 
able to screen for more than 50 cancers. 
(7) Multi-cancer early detection tests can com-
plement the covered early detection tests enacted by 
Congress and extend the benefits of early detection 
to more cancers and more Americans. Medicare cov-
erage of comprehensive multi-cancer early detection 
screening tests could substantially transform cancer 
care for Americans, and the Medicare law needs 
modernizing to provide timely coverage and keep 
pace with medical innovation. 
(b) PURPOSE.—The purpose of this Act is to create 
a covered benefit for multi-cancer early detection screen-
ing tests to ensure Medicare beneficiary access to these 
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tests without unnecessary delay once approved under the 
Federal Food, Drug, and Cosmetic Act. 
SEC. 3. 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.—The term ‘multi-cancer early detection 
screening test’ means any of the following tests, approved 
or cleared by the Food and Drug Administration, insofar 
as the Secretary determines coverage of such tests is ap-
propriate, furnished to an individual for the purpose of 
earlier detection of cancer across many cancer types (such 
as described in the National Cancer Institute’s Annual Re-
port to the Nation on the Status of Cancer): 
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‘‘(2) A genomic sequencing blood or blood prod-
uct test that includes the analysis of cell-free nucleic 
acids. 
‘‘(3) Such other equivalent tests (which are 
based on blood, blood products, urine or other sam-
ple of biological material) as the Secretary deter-
mines appropriate in providing results comparable to 
those obtained with a test described in paragraph 
(1).’’. 
(b) PAYMENT AND FREQUENCY LIMIT.— 
(1) PAYMENT UNDER FEE SCHEDULE.—Section 
1833(h) of the Social Security Act (42 U.S.C. 
1395l(h)) is amended— 
(A) in paragraph (1)(A), by inserting after 
‘‘(including’’ the following: ‘‘multi-cancer early 
detection 
screening 
tests 
under 
section 
1861(nnn), and including’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(10) No payment may be made under this 
part for a multi-cancer early detection screening test 
(as defined in section 1861(nnn)) for an individual 
if such a test was furnished to the individual during 
the previous 11 months.’’. 
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(2) 
CONFORMING
AMENDMENT.—Section 
1862(a) of the Social Security Act (42 U.S.C. 
1395y(a)) is amended— 
(A) 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 fol-
lowing new subparagraph: 
‘‘(Q) in the case of multi-cancer early de-
tection screening tests (as defined in section 
1861(lll)), which are performed more frequently 
than is covered under section 1833(h)(10);’’; 
and 
(B) 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-
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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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