Increasing Access to Lung Cancer Screening Act
- Bill Number
- S. 4566
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-05-19: Read twice and referred to the Committee on Finance. (text: CR S2377-2379)
- Last Updated
- 2026-06-12T19:33:39Z
AI-Generated Summary
Purpose The legislation aims to increase access to lung cancer screening and tobacco cessation services by mandating coverage under Medicaid, Medicare, and private health insurance plans, while eliminating cost-sharing and prior authorization barriers. It also funds public education and requires a federal report on screening gaps.
Key Provisions
- Section 2 requires state Medicaid plans to cover annual lung cancer screening for eligible individuals when recommended by U.S. Preventive Services Task Force guidelines (referencing the March 9, 2021 version, without reductions in frequency or eligibility). Coverage must occur without prior authorization or cost-sharing.
- Section 3 expands Medicaid coverage of tobacco cessation counseling and pharmacotherapy (including for e-cigarette or vape pen use) to all enrollees, removing the prior limit to pregnant women, and prohibits prior authorization.
- Section 4 prohibits prior authorization for lung cancer screening under Medicare (including Medicare Advantage) and under private group and individual health insurance plans when recommended by the U.S. Preventive Services Task Force.
- Section 5 directs the Secretary of Health and Human Services to run a targeted education and outreach campaign on lung cancer screening, with $10 million authorized annually from fiscal years 2028 through 2032.
- Section 6 requires the Comptroller General to submit a report within one year on lung cancer diagnosis and screening demographics, highlighting uncovered population segments and federal improvement recommendations.
Significant Changes to Existing Law
- Amends the Social Security Act (Sections 1905, 1916, 1916A, 1932, 1834, and 1852) to add mandatory screening coverage and remove cost-sharing and prior authorization rules for both lung cancer screening and tobacco cessation services.
- Updates the Public Health Service Act (Section 2713) to bar prior authorization in private insurance markets.
- Broadens tobacco cessation benefits beyond pregnant women and explicitly includes e-cigarette use.
- Introduces new education funding and reporting requirements not present in current law.
Potential Impacts
- On government agencies: Increases federal and state Medicaid expenditures starting in 2028; requires administrative updates for managed care contracts and cost-sharing rules.
- On citizens: Improves access to preventive services for Medicaid and Medicare beneficiaries and privately insured individuals, particularly current or former smokers, with reduced financial barriers.
- On international relations: None identified in the legislation.
Main Stakeholders Affected
- Medicaid enrollees and state Medicaid agencies.
- Medicare beneficiaries and Medicare Advantage plans.
- Private health insurance issuers and enrollees.
- Health care providers delivering screenings or cessation services.
- Patient advocacy groups and individuals at elevated lung cancer risk.
- The Department of Health and Human Services and the Government Accountability Office.
Notable Legal, Constitutional, or Political Implications
- The bill relies on conditional federal funding mechanisms under the Social Security Act, with delayed effective dates (January 1, 2028) and state legislative exceptions that may delay implementation in some states.
- It creates uniform national standards for preventive coverage without altering state flexibility beyond the new mandates.
- No direct constitutional issues are raised in the text; changes focus on statutory amendments to existing health programs.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Sen. Durbin, Richard J. [D-IL]
Cosponsors (1)
Recent Actions
- 2026-05-19: Read twice and referred to the Committee on Finance. (text: CR S2377-2379)
- 2026-05-19: Introduced in Senate
Bill Versions
- Increasing Access to Lung Cancer Screening Act — issued 2026-05-19 — PDF (13 pages)