Medicare expands coverage for precision lung cancer testing
H.R. 6321 — Lung Cancer Medicare Access to Precise Testing Act · Filed by Josh Gottheimer (D-NJ) · 3 cosponsors · Introduced Nov 28, 2025 · Referred to committee
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What it does
This bill requires Medicare to cover lung cancer biomarker testing—tests that identify specific genetic or molecular markers in a patient's tumor to guide treatment—starting January 1, 2027. Medicare will pay 100% of reasonable charges for these tests when furnished to individuals already diagnosed with lung cancer, with no patient cost-sharing.
Why we flagged it
The bill's sole operative mechanism is to add a diagnostic service to Medicare's covered benefits and mandate full payment. It is a straightforward coverage mandate with no riders, carve-outs, or hidden provisions.
What the text implies
- Effective date (January 1, 2027) gives manufacturers and labs ~2 years to prepare; early adoption may occur before the mandate takes effect.
- Definition of 'reasonable charges' is not specified in this bill—it will be determined by CMS rulemaking, creating potential for future disputes over reimbursement rates.
The full analysis lists 4 implications of this text.
Who stands to gain
diagnostic laboratory companies; biomarker testing manufacturers; genomic sequencing service providers