Health plans would cover genetic testing for people at ovarian cancer risk

Group and individual health plans would cover genetic counseling and testing. Coverage would apply to people with ovarian cancer or endometrial cancer when cancer care guidelines recommend counseling or testing. It would also cover people whose family history points to hereditary ovarian cancer, Lynch syndrome, or another inherited syndrome linked to higher ovarian cancer risk. Plans would also cover repeat or broader testing when the treating provider finds it medically necessary and appropriate. The coverage rule would apply to plan years beginning on or after the date one year after enactment.

Group and individual health plans would cover care aimed at finding ovarian cancer early or lowering its risk. Coverage would apply to people identified as having high inherited risk, even if they have never had ovarian or endometrial cancer. The care must follow nationally recognized cancer care guidelines. Patients would not have to receive testing or preventive care. The coverage rule would apply to plan years beginning on or after the date one year after enactment.

Federal health officials would direct ovarian cancer education toward higher-risk groups and award grants to test outreach strategies. Outreach would focus on people at higher risk and communities with less access to care. Grants would test ways to improve awareness, testing, and access to specialty care. Grant applicants experienced in serving rural, underserved, or high-risk groups would get preference. Congress would still need to set aside money for the authorized activities. The bill would authorize $20 million a year for these activities in fiscal years 2027 through 2031.