Bill to Improve Access to Genetic Counseling Introduced in House and Senate

By Matt Devino, MPH

On April 29, S. 1450 (“A bill to amend title XVIII of the Social Security Act to provide for expanded coverage of services furnished by genetic counselors under part B of the Medicare program, and for other purpose”) was introduced into the Senate by the bill’s co-sponsors, Sen. Jon Tester (D-MT) and Sen. John Barrasso (R-WY). A House version of the bill with the same title (H.R. 2144) was introduced on March 23, sponsored by Rep. Brian Higgins (D-NY). 

Both bills were developed with the help of the National Society of Genetic Counselors. If passed, the bills would authorize the Centers for Medicare and Medicaid Services (CMS) to recognize certified genetic counselors (CGCs^®) as healthcare providers, giving beneficiaries improved access to the services CGCs® provide. A sign of the growing recognition of the value of genetic testing services, the National Comprehensive Cancer Network has recommended these services for patients with many cancer types.  

Currently, genetic counselors must provide services under “direct” supervision, which means they are only available to beneficiaries when they are being supervised by a Medicare-certified healthcare provider (i.e., physician or nurse practitioner). H.R. 2144 would allow genetic counselors to bill Medicare directly and be reimbursed for their services at 85 percent of physician billing.

As personalized medicine and genetic markers are increasingly used to inform cancer treatment plans, coverage for the services of genetic counselors is essential for beneficiaries. In March 2021, ACCC joined other stakeholders in stating our support of the Access to Genetic Counselors Services Act "to update Medicare law and improve access to genetic counselors for Medicare beneficiaries." ACCC supports S.1450 and H.R. 2144 and will continue to champion legislative efforts that improve access to and reimbursement for quality cancer care to better enable our members to provide much needed-services to their patients.