I 
117TH CONGRESS 
1ST SESSION H. R. 4110 
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 
JUNE 23, 2021 
Ms. WASSERMAN SCHULTZ (for herself, Mrs. MILLER-MEEKS, Ms. SLOTKIN, 
and Mr. RODNEY DAVIS 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 subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions 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 re-
duce the risk for individuals with a germline (inherited) 
mutation associated with a high risk of developing a 
preventable cancer. 
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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 ‘‘Reducing Hereditary 
Cancer Act of 2021’’. 
SEC. 2. HEREDITARY CANCER GENETIC TESTING OF INDI-
VIDUALS WITH A FAMILY HISTORY OF A HE-
REDITARY CANCER GENE MUTATION OR PER-
SONAL OR FAMILY HISTORY SUSPICIOUS FOR 
HEREDITARY CANCER. 
(a) COVERAGE.—Section 1861 of the Social Security 
Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (GG); 
(B) by striking the period and inserting ‘‘; 
and’’ at the end of subparagraph (HH); and 
(C) by inserting after subparagraph (HH) 
the following new subparagraph: 
‘‘(II) in the case of an individual with a 
personal or family history of a hereditary can-
cer gene mutation or a personal or family his-
tory suspicious for hereditary cancer, germline 
mutation testing.’’; and 
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(2) by adding at the end the following new sub-
section: 
‘‘(lll) GERMLINE MUTATION TESTING.—The term 
‘germline mutation testing’ means genetic testing for 
germline mutations that is in accordance with evidence- 
based, clinical practice guidelines specifically addressing 
genetic testing, screening, and management of individuals 
with inherited mutations associated with increased cancer 
risk that— 
‘‘(1) have been developed by a nationally recog-
nized oncology professional organization, including 
the National Comprehensive Cancer Network, the 
American Society of Clinical Oncology, the Society 
of Gynecologic Oncology, or any other oncology pro-
fessional organization specified by a medicare ad-
ministrative contractor with a contract under section 
1874A; and 
‘‘(2) in the case of conflicting guidelines devel-
oped by more than one nationally recognized oncol-
ogy professional organization, the least restrictive of 
such guidelines, as determined by such a medicare 
administrative contractor.’’. 
(b) FREQUENCY.—Section 1862(a)(1) of the Social 
Security Act (42 U.S.C. 1395y(a)(1)) is amended— 
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(1) by striking ‘‘and’’ at the end of subpara-
graph (O); 
(2) by adding ‘‘and’’ at the end of subpara-
graph (P); and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(Q) in the case of germline mutation test-
ing as defined in section 1861(lll), which is per-
formed more than once with respect to an indi-
vidual described in such section;’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to testing furnished on or after 
the date of the enactment of this Act. 
SEC. 3. COVERAGE OF CERTAIN PREVENTIVE SURGERIES. 
(a) IN GENERAL.—Section 1862 of the Social Secu-
rity Act (42 U.S.C. 1395y) is amended by adding at the 
end the following new subsection: 
‘‘(p) COVERAGE OF CERTAIN RISK-REDUCING SUR-
GERIES.—In the case of an individual described in section 
1861(s)(2)(II) for whom, based on evidence-based, clinical 
practice guidelines described in section 1861(lll), surgery 
would reduce the risk of developing cancer, such risk-re-
ducing surgery shall be considered reasonable and nec-
essary for treatment 
of 
illness 
under 
subsection 
(a)(1)(A).’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to items and services furnished 
on or after the date of the enactment of this Act. 
SEC. 4. COVERAGE OF EVIDENCE-BASED SCREENINGS FOR 
INDIVIDUALS WITH A HEREDITARY CANCER 
GENE MUTATION. 
(a) IN GENERAL.—Section 1862 of the Social Secu-
rity Act (42 U.S.C. 1395y), as amended by section 3, is 
amended by adding at the end the following new sub-
section: 
‘‘(q) COVERAGE OF EVIDENCE-BASED SCREENINGS 
FOR INDIVIDUALS WITH A HEREDITARY CANCER GENE 
MUTATION.—In the case of an individual who is deter-
mined pursuant to genetic testing to have a hereditary 
cancer (germline) gene mutation, the Secretary shall in-
crease any frequency limitations (or other limitations on 
coverage otherwise applicable under this title) for any evi-
dence-based screenings furnished to such individual, to be 
in compliance with evidence-based, clinical practice guide-
lines described in section 1861(lll), or as determined ap-
propriate by the Secretary, but not less frequently than 
on an annual basis. For the purposes of this subsection, 
evidence-based screenings shall include screening mam-
mography, breast screening MRI, colonoscopy, PSA test-
ing, and any additional evidence-based screening modali-
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ties appropriate for high-risk individuals as recommended 
by such guidelines.’’. 
(b) CONFORMING
AMENDMENT
FOR
SCREENING 
MAMMOGRAPHY.—Section 1834(c)(2)(A) of the Social Se-
curity Act (42 U.S.C. 1395m(c)(2)(A)) is amended, in the 
matter preceding clause (i), by striking ‘‘subparagraph 
(B)’’ and inserting ‘‘subparagraph (B) and section 
1862(q)’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after the date of the enactment of this Act. 
Æ 
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