Under current law, Medicare covers genetic testing only for beneficiaries already diagnosed with cancer, regardless of family cancer history or a known genetic mutation in the family. This is a problem because knowledge of an inherited mutation can be lifesaving for an individual and their family members, as it guides decisions regarding cancer screening and prevention.

The Reducing Hereditary Cancer Act aims to address gaps in Medicare coverage so individuals at high risk of cancer have access to these crucial services. The Reducing Hereditary Cancer Act aims to address gaps in Medicare coverage so individuals at high risk of cancer have access to these crucial services. This legislation amends Medicare to:

1. Require coverage of guideline-recommended genetic testing for inherited mutations known to significantly increase cancer risk in two Medicare populations:
(i) those with a known hereditary cancer mutation in their family, and
(ii) those with a personal or family history suspicious for hereditary cancer.

2. Require coverage of appropriate follow-up services for Medicare beneficiaries who have an inherited mutation causing an increased risk of cancer:
(i) increased cancer screening (e.g., breast MRIs, more frequent colonoscopies) and
(ii) risk-reducing surgeries (e.g., removal of ovaries and fallopian tubes).

These services are covered for Americans with private insurance and Medicaid, but unfortunately not Medicare. Lack of access to these lifesaving services exacerbates health disparities and adversely affects Medicare beneficiaries, Medicare, and the U.S. healthcare system as a whole. With access to more early detection, individuals would detect cancer earlier when it is more easily treated, better understand their personal cancer risks for multiple cancers, make informed decisions about the type and frequency of cancer screenings, and inform family members about their potential cancer risks.