Bill > S3607

This bill, titled the "Access to Genetic Counselor Services Act of 2026," aims to expand Medicare coverage for services provided by genetic counselors under Part B of the Medicare program, which covers outpatient services. Specifically, it amends the Social Security Act to define "covered genetic counseling services" as those furnished by a licensed or certified genetic counselor starting January 1, 2027, and includes services and supplies incidental to this counseling that a genetic counselor is legally authorized to perform. The bill clarifies that a genetic counselor is either licensed by the state they practice in or, if the state doesn't license them, certified by the American Board of Genetic Counseling and meets other criteria set by the Secretary of Health and Human Services. It also addresses balance billing, ensuring genetic counselors are included in provisions that prevent overcharging Medicare beneficiaries, and establishes payment for these services at 80 percent of the lesser of the actual charge or 85 percent of the fee schedule amount that would apply if a physician provided the service. The bill also makes conforming amendments to ensure these services are not excluded from Medicare coverage and clarifies that it does not prevent physicians or other healthcare providers from billing for genetic counseling services if they are otherwise covered. Finally, it allows the Secretary of Health and Human Services to implement these changes through an interim final rule.

Budget and Finance

https://www.congress.gov/bill/119th-congress/senate-bill/3607/all-info