Under current Medicare guidelines, only those with “signs, symptoms, complaints, or personal histories of disease” meet the criteria for medical services coverage. Thus, genetic testing is only covered for those already diagnosed with cancer, regardless of family history. If someone without cancer has an inherited mutation that increases cancer risk (e.g., BRCA1/2), Medicare may not cover recommended high-risk cancer screenings or risk reducing procedures. While Medicare now covers certain cancer screenings for the “average risk” population, those at high-risk do not have recommended screening or prevention covered through Medicare.
The Reducing Hereditary Cancer Act was recently proposed to fix this problem and ensure Medicare beneficiaries have access to inherited cancer genetic testing as well as recommended screening and risk-reducing procedures, when medically necessary and appropriate. The bill was introduced in the House by Rep. Debbie Wasserman Schultz (D-FL-23) on June 23rd, 2021 and has secured bipartisan support.
For more information about this bill, please visit https://tinyurl.com/HR4110 and https://tinyurl.com/forcerhca2021. You may also watch FORCE’s Community & Stakeholder Advocacy Briefing at https://tinyurl.com/forcerhca2021-briefing. Lastly, we encourage you to ask your elected representatives to support this important legislation! Find your
representative at https://tinyurl.com/find-your-representatives.