S. 2760: Reducing Hereditary Cancer Act of 2025

This bill, known as the Reducing Hereditary Cancer Act of 2025, aims to enhance coverage for genetic testing and preventative measures related to hereditary cancers under Medicare. Here’s a breakdown of its key provisions:

1. Genetic Testing Coverage

• The bill mandates that Medicare will cover genetic testing for individuals who either have a personal or family history of hereditary cancer gene mutations or exhibit a history that suggests a risk for hereditary cancer.
• It specifies that genetic tests must adhere to established clinical practice guidelines from recognized oncology organizations, ensuring that testing is based on scientific evidence.

2. Frequency of Testing

• The bill allows for multiple genetic tests under Medicare for those who qualify, lifting limitations on how often these tests can be performed.
• This provision ensures that individuals can receive ongoing assessments based on medical necessity as determined by healthcare providers.

3. Coverage of Preventive Surgeries

• It provides for Medicare coverage of preventive surgeries for individuals identified as having high cancer risk due to hereditary factors, where such surgeries are deemed necessary according to clinical guidelines.
• The bill stipulates that these risk-reducing surgeries should be classified as a reasonable and necessary treatment for those at high risk of developing cancer.

4. Evidence-Based Screening Coverage

• The legislation requires increased coverage for various evidence-based screenings for individuals with hereditary cancer gene mutations. This includes, but is not limited to, mammograms, MRIs, colonoscopies, and PSA testing.
• Screenings must be conducted at least annually or as frequently as recommended by clinical guidelines, aiming to facilitate early detection of potential cancers.

5. Effective Date

• The amendments proposed by this bill would be effective for testing and surgical services provided on or after the date of its enactment.

Relevant Companies

• ILMN (Illumina, Inc.): This company specializes in genetic sequencing and may see increased demand for its testing services as more individuals seek genetic testing for hereditary cancer risks.
• ABBV (AbbVie Inc.): As a biopharmaceutical company, AbbVie might be affected by changes in cancer treatment protocols, particularly if preventative surgeries or screenings become more prevalent.