Health plans would cover ovarian cancer testing and prevention care

Group and individual health plans would cover listed genetic counseling and testing, early detection, and risk-reducing care. Testing coverage would apply to people with a personal history of ovarian cancer, certain people with endometrial cancer, and people whose family history points to an inherited cancer syndrome. Repeat or expanded testing must be medically necessary and appropriate, as determined by the treating health care provider. Prevention coverage must follow nationally recognized cancer-care guidelines; for the scope of testing, the least restrictive guideline applies when guidelines conflict. People would not have to receive these services, and plans could still negotiate payment terms with providers. The coverage rules would apply to plan years beginning one year after enactment or later.

HHS would conduct targeted education and award grants to test outreach and care-access strategies. Eligible applicants would include public health agencies, community health centers, rural hospitals, academic medical centers, nonprofit groups, and other entities HHS considers appropriate. HHS would favor grant applicants experienced in serving rural, medically underserved, or high-risk groups. The bill would authorize, but not directly provide, $20 million each year for the campaign and grant work. The $20 million annual authorization would cover fiscal years 2027 through 2031; initial grant reports would be due within three years after awards, then annually.

Federal rural health programs would include ovarian cancer care in their listed work. The outreach-grant language covers prevention, diagnosis, treatment, survivorship support, inherited-risk assessment, genetic counseling, and care coordination; it also expressly mentions Tribal communities.