Bill > HR6280

This bill would amend the Social Security Act to expand Medicare coverage of genetic counseling services, specifically allowing genetic counselors to directly bill Medicare for their services starting January 1, 2027. The bill defines a genetic counselor as either a state-licensed professional or, in states without licensing, someone certified by the American Board of Genetic Counseling who meets additional criteria established by the Secretary of Health and Human Services. Medicare would cover these services and pay genetic counselors 80% of the lesser of the actual charge or 85% of the fee schedule that would apply for a physician providing similar services. The legislation ensures that genetic counselors can be reimbursed for services they are legally authorized to perform under state law, while also clarifying that physicians and other healthcare providers can continue to bill for genetic counseling services. The bill allows the Secretary of Health and Human Services to implement these changes through an interim final rule, providing flexibility in the rollout of the new coverage. This expansion aims to increase access to professional genetic counseling services for Medicare beneficiaries by recognizing genetic counselors as direct healthcare providers.

Business and Industry

https://www.congress.gov/bill/119th-congress/house-bill/6280/all-info