H.R. 6321: Lung Cancer Medicare Access to Precise Testing Act

This bill, known as the Lung Cancer Medicare Access to Precise Testing Act, aims to enhance Medicare coverage for lung cancer patients by requiring coverage for lung cancer biomarker testing. Here are the key components of the bill:

1. Coverage Requirements

The bill proposes to amend the Social Security Act to include:

• The addition of lung cancer biomarker testing to the list of services covered under Medicare.
• Lung cancer biomarker testing is defined as tests aimed at identifying specific biomarkers such as genes, proteins, or other molecules in patients diagnosed with lung cancer. These tests can analyze tissue, blood, or other bodily fluids.

2. Implementation Timeline

The requirement for coverage will take effect for tests performed on or after January 1, 2027. This gives time for the implementation of the changes in the Medicare system.

3. Payment Provisions

The bill also includes specifics on payment for these tests, stating that:

• Medicare will reimburse the costs for lung cancer biomarker testing at 100% of the reasonable charges incurred for such testing.
• This establishes a comprehensive payment policy that could improve access for patients needing these tests as part of their cancer diagnosis and treatment plan.

4. Legislative Process

As of now, the bill has been introduced in the House of Representatives and is under review by two committees: the Committee on Energy and Commerce and the Committee on Ways and Means.

Relevant Companies

• ILMN (Illumina, Inc.): Illumina is a company that specializes in DNA sequencing and array-based solutions. The amendment could lead to increased demand for biomarker testing services, potentially benefiting its business operations.
• EXAS (Exact Sciences Corporation): This company focuses on cancer screening and diagnostic products. With an increased coverage of lung cancer biomarker testing, their offerings may see higher utilization rates.
• MDGL (Madrigal Pharmaceuticals): As a company working on treatments that target specific genetic markers, they may benefit from testing coverage that aligns with their therapeutic offerings.