I 
119TH CONGRESS 
1ST SESSION H. R. 6178 
To amend title XIX of the Social Security Act to require coverage under 
State plans under the Medicaid program for annual lung cancer screening 
with no cost sharing for individuals for whom screening is recommended 
by U.S. Preventive Services Task Force guidelines, to expand coverage 
under Medicaid of counseling and pharmacotherapy for cessation of to-
bacco use, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 20, 2025 
Ms. CASTOR of Florida (for herself, Mr. FITZPATRICK, and Ms. WASSERMAN 
SCHULTZ) introduced the following bill; which was referred to the Com-
mittee 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 XIX of the Social Security Act to require 
coverage under State plans under the Medicaid program 
for annual lung cancer screening with no cost sharing 
for individuals for whom screening is recommended by 
U.S. Preventive Services Task Force guidelines, to ex-
pand coverage under Medicaid of counseling and 
pharmacotherapy for cessation of tobacco use, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Increasing Access to 
Lung Cancer Screening Act’’. 
SEC. 2. MEDICAID COVERAGE OF ANNUAL LUNG CANCER 
SCREENING WITH NO COST SHARING FOR 
CERTAIN INDIVIDUALS. 
(a) IN GENERAL.—Section 1905(a)(4) of the Social 
Security Act (42 U.S.C. 1396d(a)(4)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(F)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘; and (G) an annual lung cancer 
screening for individuals who are eligible under the 
plan and for whom such screening is recommended 
under guidelines published by the United States Pre-
ventive Services Task Force, without regard to prior 
authorization’’. 
(b) NO COST SHARING.— 
(1) IN
GENERAL.—Subsections (a)(2) and 
(b)(2) of section 1916 of the Social Security Act (42 
U.S.C. 1396o) are each amended— 
(A) in subparagraph (G), by adding at the 
end ‘‘, or’’; and 
(B) by adding at the end the following new 
subparagraph: 
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scribed for purposes of promoting, and when 
used to promote, tobacco cessation in accord-
ance with the Guideline referred to in section 
1905(bb)(2)(A); and’’. 
(3) Section 1916A(b)(3)(B) of such Act (42 
U.S.C. 1396o–1(b)(3)(B)), as amended by section 1, 
is further amended— 
(A) in clause (iii), by striking ‘‘, and coun-
seling and pharmacotherapy for cessation of to-
bacco use by pregnant women (as defined in 
section 1905(bb))’’; and 
(B) by adding at the end the following new 
clause: 
‘‘(xv) 
Counseling 
and 
pharmacotherapy for cessation of tobacco 
use (as defined in section 1905(bb)).’’. 
(c) APPLICATION TO MEDICAID MANAGED CARE OR-
GANIZATIONS.—Section 1932(b) of the Social Security Act 
(42 U.S.C. 1396u–2(b)), as amended by section 1, is fur-
ther amended by adding at the end the following new para-
graph: 
‘‘(10) CESSATION
OF
TOBACCO
USE.—Each 
contract with a medicaid managed care organization 
under section 1903(m) shall require the organization 
to 
provide 
coverage 
for 
counseling 
and 
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pharmacotherapy for cessation of tobacco use with-
out regard to prior authorization.’’. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by this section shall apply 
with respect to items and services furnished on or 
after January 1, 2026. 
(2) EXCEPTION
IF
STATE
LEGISLATION
RE-
QUIRED.—In the case of a State plan for medical as-
sistance under title XIX of the Social Security Act 
which the Secretary of Health and Human Services 
determines requires State legislation (other than leg-
islation appropriating funds) in order for the plan to 
meet the additional requirements imposed by the 
amendments made by this section, the State 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 additional requirements 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 previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of such session shall be 
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deemed to be a separate regular session of the State 
legislature. 
SEC. 4. COVERAGE UNDER MEDICARE AND PRIVATE 
HEALTH INSURANCE OF ANNUAL LUNG CAN-
CER 
SCREENING 
WITHOUT 
UTILIZATION 
MANAGEMENT REQUIREMENTS. 
(a) MEDICARE.— 
(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: 
‘‘(z) SPECIAL RULE FOR ANNUAL LUNG CANCER 
SCREENING.—Notwithstanding any other provision of this 
title, in the case of an annual lung cancer screening for 
which benefits are provided under this part for any indi-
vidual for whom such screening is recommended in accord-
ance with guidelines issued by the Secretary, such benefits 
shall be provided without application of any prior author-
ization.’’. 
(2) APPLICATION
UNDER
MEDICARE
ADVAN-
TAGE.—Section 1852(a)(1)(B) of the Social Security 
Act (42 U.S.C. 1395w–22(a)(1)(B)) is amended by 
adding at the end the following new clause: 
‘‘(vii) PROHIBITION OF APPLICATION 
OF CERTAIN REQUIREMENTS FOR ANNUAL 
LUNG CANCER SCREENING.—In the case of 
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an annual lung cancer screening for which 
benefits are provided under part B for any 
individual for whom such screening is rec-
ommended in accordance with guidelines 
issued by the Secretary for purposes of 
section 1834(z), an MA plan may not im-
pose any prior authorization with respect 
to the coverage of such screening under 
such plan.’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply with respect to serv-
ices furnished on or after January 1, 2026. 
(b) INDIVIDUAL AND GROUP HEALTH INSURANCE 
MARKETS.— 
(1) IN GENERAL.—Section 2713 of the Public 
Health Service Act (42 U.S.C. 300gg–(3)) is amend-
ed by adding at the end the following new sub-
section: 
‘‘(d) PROHIBITION OF APPLICATION OF CERTAIN RE-
QUIREMENTS FOR ANNUAL LUNG CANCER SCREENING.— 
A group health plan and a health insurance issuer offering 
group or individual health insurance coverage may not im-
pose any prior authorization with respect to the benefits 
under such plan or coverage for an annual lung cancer 
screening for any individual for whom such screening is 
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recommended by the United States Preventive Services 
Task Force.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply with respect to plan 
years beginning on or after January 1, 2026. 
SEC. 5. LUNG CANCER SCREENING EDUCATION AND OUT-
REACH. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), in consultation with patient and lung cancer ad-
vocacy groups, shall conduct an education and outreach 
campaign for purposes of informing individuals and health 
care providers of— 
(1) the importance of lung cancer screenings; 
and 
(2) the categories of individuals who should re-
ceive such screenings. 
(b) MANNER OF OUTREACH.—The Secretary may 
carry out the campaign described in subsection (a) di-
rectly, by contract, through the issuance of grants, or oth-
erwise. In carrying out such campaign, the Secretary shall 
ensure that the campaign is targeted to reach individuals 
at high risk of lung cancer. 
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(c) FUNDING.—There are authorized to be appro-
priated $10,000,000 for each of fiscal years 2026 through 
2030 for purposes of carrying out this section. 
SEC. 6. REPORT. 
Not later than 1 year after the date of the enactment 
of this Act, the Comptroller General of the United States 
shall conduct a study and submit to Congress a report 
on the demographics of individuals diagnosed with lung 
cancer and individuals screened for such cancer. Such re-
port shall identify— 
(1) any segments of the population diagnosed 
with lung cancer but not captured in current screen-
ing eligibility guidelines (such as firefighters, vet-
erans, and women under 50 years of age); and 
(2) actions the Federal Government could take 
to improve screening for such cancer among such 
segments. 
Æ 
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