This bill provides for Medicare coverage of germline mutation testing for individuals with a personal or family history of a hereditary cancer gene mutation or suspected history of hereditary cancer, as well as for associated coverage of risk-reducing surgeries and screenings. Here is a one pager about the bill from Facing Our Risk of Cancer Empowered (FORCE).
This bill expands Medicare coverage of intensive behavioral therapy for obesity. Specifically, the bill allows coverage for therapy that is provided by (1) a physician who is not a primary care physician; or (2) other health care providers (e.g., physician assistants and nurse practitioners) and approved counseling programs, if provided upon a referral from, and in coordination with, a physician or primary care practitioner. Currently, such therapy is covered only if provided by a primary care practitioner.
The bill also allows coverage under Medicare's prescription drug benefit of drugs used for the treatment of obesity or for weight loss management for individuals who are overweight.
This bill requires health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications.
This is legislation to amend title XIX of the Social Security Act to require coverage under State plans under the Medicaid program for annual lung cancer screening with no cost sharing for individuals for whom screening is recommended by U.S. Preventive Services Task Force guidelines, to expand coverage under Medicaid of counseling and pharmacotherapy for cessation of tobacco use, and for other purposes.
A bill to address the health of cancer survivors and unmet needs that survivors face through the entire continuum of care from diagnosis through active treatment and posttreatment, in order to improve survivorship, treatment, transition to recovery and beyond, quality of life and palliative care, and long-term health outcomes, including by developing a minimum standard of care for cancer survivorship, irrespective of the type of cancer, a survivor's background, or forthcoming survivorship needs, and for other purposes.
This bill is the Promoting Resources to Expand Vaccination, Education and New Treatments for HPV Cancers Act or the PREVENT HPV Cancers Act with the ultimate goal of preventing HPV-related cancers.
This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer.
A request for such an exception to the protocol must be granted if (1) an otherwise required treatment has been ineffective, (2) such treatment is expected to be ineffective and delaying effective treatment would lead to irreversible consequences, (3) such treatment will cause or is likely to cause an adverse reaction to the individual, (4) such treatment is expected to prevent the individual from performing daily activities or occupational responsibilities, (5) the individual is stable based on the prescription drugs already selected, or (6) there are other circumstances as determined by the Employee Benefits Security Administration.
The bill requires a group health plan to implement and make readily available a clear process for an individual to request an exception to the protocol, including required information and criteria for granting an exception. The bill further specifies timelines under which plans must respond to such requests.
To conduct or support cancer research, the bill would appropriate, for each of fiscal years 2023 through 2027, to the National Institutes of Health, out of amounts in the Treasury not otherwise appropriated, an amount that is equal to 25 percent of the total amount allocated to the National Institutes of Health for cancer research for fiscal year 2021, to remain available until expended. Amounts appropriated pursuant to the preceding sentence shall be in addition to amounts otherwise made available to the National Institutes of Health for cancer research.
This bill would authorize appropriations for offsetting the costs related to reductions in research productivity resulting from the coronavirus pandemic.
This bill would provide temporary licensing reciprocity for telehealth and interstate health care treatment during national emergencies.
This is a bill to prove 5% real funding increases to National Institutes of Health (NIH), Centers for Disease Control (CDC), Department of Defense (DoD) medical research, and Department of Veterans Affairs (VA) medical research for each of the next ten fiscal years.
The main provisions of this bill are: 1) enabling more routine financial support from trial sponsors for patient non-medical costs associated with clinical trial participation, 2) clarifying sponsors can provide technology for patients to participate remotely in clinical trials, and 3) requiring HHS to develop guidance on ways decentralized clinical trials can be employed to increase trial diversity. Taken together, these provisions can open the door for more patients to participate in clinical trials, but who currently face financial or logistical barriers to doing so.
This bill includes certain lymphedema compression treatment items as covered durable medical equipment under Medicare. (Lymphedema is a condition of localized fluid retention and tissue swelling that is caused when the lymphatic system is damaged or blocked.)
This bill waives Medicare coinsurance requirements with respect to colorectal cancer screening tests, regardless of the code billed for a resulting diagnosis or procedure, was signed into law as a provision in the FY2021 budget and COVID-19 response legislation, in section 122. Fight Colorectal Cancer provides a nice summary of the bill's history.
This bill, which requires state Medicaid programs to cover routine patient costs for items and services that are provided in connection with a qualifying clinical trial regarding cancer or other life-threatening conditions, was signed into law on December 27, 2020 as a part of H.R.133 - Consolidated Appropriations Act, 2021.