The House passed a bipartisan healthcare funding package Jan. 22. The most recent version includes a provision addressing Medicare coverage for multi-cancer early detection screenings.
The bill is now in the Senate’s hands. If it passes, Medicare beneficiaries would also receive expanded coverage for infusion equipment and drugs, along with pharmacy access protections.
Here are seven things to know about coverage of multi-cancer screenings:
1. Coverage would not begin until Jan. 1, 2029.
2. Screenings would encompass several cancer types across various organ sites.
3. CMS would receive $2 million in fiscal 2026 to implement.
4. All tests would need to be cleared by the FDA, and blood-based genomic sequencing — or a similar procedure — would be a requirement.
5. The accessibility of these screenings would not replace other tests, such as those for breast and lung cancer.
6. Through 2030, Medicare would pay the same amount for the screenings as multi-target stool DNA tests.
7. Individuals under age 50 and those who received a test in the past 11 months are not eligible for coverage.
