Lung Cancer Screening and Prevention Act of 2025

Bill Number

H.R. 1406

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-02-18: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Last Updated

2026-06-11T23:26:38Z

AI-Generated Summary

Purpose

The Lung Cancer Screening and Prevention Act of 2025 aims to expand Medicare coverage for lung cancer screening tests. It builds on existing coverage by authorizing the inclusion of additional FDA-approved or cleared screening methods as preventive services, with the goal of improving early detection of lung cancer among eligible beneficiaries.

Key Provisions

• Expansion of Coverage: Amends Section 1834(n) of the Social Security Act to allow the Secretary of Health and Human Services (HHS) to cover new lung cancer screening tests beyond the current national coverage determination (NCD) for low-dose computed tomography (CT) scans. These new tests must be cleared or approved by the Food and Drug Administration (FDA) and are treated as preventive services under Medicare Part B.
• Eligibility and Limits: Coverage applies to "appropriate individuals" as determined by the HHS Secretary, with frequency and payment limits set in consultation with relevant organizations (e.g., medical experts).
• Decision-Making Process: Uses the standard national coverage determination (NCD) process—a formal HHS review to decide if a service is "reasonable and necessary" for Medicare coverage—but waives the requirement for an evidence development plan (a step that mandates data collection on the test's effectiveness). The Secretary may consider recommendations from expert groups, such as those convened by HHS or the Agency for Healthcare Research and Quality (AHRQ).
• Effective Date: Changes take effect on the date of enactment and apply to Medicare Part B preventive services provided on or after that date.

Significant Changes to Existing Law

• From Current Medicare Rules: Previously, Medicare covered only low-dose CT scans for lung cancer screening under a specific NCD (210.14) for high-risk individuals (e.g., aged 55-77 with heavy smoking history). This bill removes barriers to covering other FDA-approved tests without needing full evidence development, streamlining approvals while maintaining the NCD framework.
• Structural Amendments: Reorganizes the law's text for clarity and adds a new paragraph explicitly granting authority for expanded coverage, overriding some prior limitations on preventive services.

Potential Impacts

• On Citizens: Medicare beneficiaries at risk for lung cancer (e.g., older adults with smoking history) gain access to potentially more advanced or less invasive screening options at no or low cost under Part B, which could lead to earlier diagnoses and better health outcomes. However, it may increase overall healthcare utilization.
• On Government Agencies: HHS and the Centers for Medicare & Medicaid Services (CMS) will handle expanded coverage decisions, potentially increasing administrative workload and program costs (estimated in billions over time due to broader screenings). The FDA's role in approvals remains unchanged but could see more scrutiny on lung cancer tests.
• On International Relations: No direct impact, as this is a domestic Medicare policy focused on U.S. healthcare.

Main Stakeholders Affected

• Medicare Beneficiaries: Primary beneficiaries, especially high-risk groups like long-term smokers aged 50 and older, who may benefit from easier access to screenings.
• Healthcare Providers: Doctors, radiologists, and screening facilities that offer lung cancer tests, as expanded coverage could boost demand and reimbursements.
• Government Entities: HHS, CMS (for coverage implementation), and FDA (for test approvals); also AHRQ and expert panels for recommendations.
• Advocacy and Industry Groups: Organizations like the American Cancer Society or medical device manufacturers developing screening technologies, which could influence or benefit from the policy.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens preventive care under Medicare by providing flexibility in coverage without altering core eligibility rules, potentially reducing future litigation over "medically necessary" services. The waiver of evidence development requirements could face challenges if seen as bypassing scientific rigor, but it aligns with existing NCD flexibilities.
• Constitutional: No significant issues; it operates within Congress's authority to regulate interstate commerce and spending for public health programs like Medicare.
• Political: Supports bipartisan health priorities (introduced by a mix of Republicans and Democrats), emphasizing cancer prevention amid rising healthcare costs. It may influence future budgets, as expanded screenings could add to Medicare's $800+ billion annual spending, prompting debates on fiscal responsibility versus public health benefits.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Buchanan, Vern [R-FL-16]

Cosponsors (9)

Rep. Kennedy, Timothy M. [D-NY-26], Rep. Griffith, H. Morgan [R-VA-9], Rep. LaHood, Darin [R-IL-16], Rep. Soto, Darren [D-FL-9], Rep. Wasserman Schultz, Debbie [D-FL-25], Rep. Bresnahan, Robert P. [R-PA-8], Rep. Neguse, Joe [D-CO-2], Rep. Tonko, Paul [D-NY-20], Rep. Lieu, Ted [D-CA-36]

Recent Actions

• 2025-02-18: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-02-18: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-02-18: Introduced in House
• 2025-02-18: Introduced in House

Bill Versions

• Lung Cancer Screening and Prevention Act of 2025 — issued 2025-02-18 — PDF (4 pages)