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RHCA Would Expand Medicare Coverage of Genetic Cancer Screening

by | Apr 27, 2022 | Articles, News, Open Content

Recently introduced bill would require coverage of genomic cancer testing and follow-up screening for certain at-risk individuals.

Current Medicare policies limiting coverage of genetic cancer testing to already diagnosed cases is out of step with current science and medical practice, which recognizes the importance of early detection in preventing cancer deaths as well as costly, often unnecessary medical interventions. With that in mind, on Feb. 16, senators from each party introduced a bill called the Reducing Hereditary Cancer Act of 2022 (RHCA) that would require Medicare to cover genomic cancer testing and follow-up screening for individuals with a family history of hereditary cancer. Specifically, it would mandate Medicare coverage of:

  • Genetic testing for germline mutations for individuals with a known, hereditary cancer gene mutation in their family or a history otherwise suspicious for hereditary cancer, subject to a limit of one per individual;
  • Risk-reducing surgeries for patients found to have a hereditary cancer mutation, coverage where such procedures are endorsed by evidence-based guidelines from groups; and
  • Increased preventive screening frequency where genetic testing determines that an individual has a hereditary cancer gene mutation, increased frequency for evidence-based screenings, at least once a year or at greater frequencies determined in accordance with (National Comprehensive Cancer Network) NCCN guidelines or the U.S. Department of Health & Human Services (HHS) Secretary.

A similar bill, also called the RHCA, has been proposed in the House.

Learn more in the upcoming May 2022 issue of National Lab Reporter.