119-s1410

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1410 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 1410

 To provide for health coverage with no cost-sharing for additional 
 breast screenings for certain individuals at greater risk for breast 
 cancer.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 April 10, 2025

 Ms. Klobuchar (for herself and Mr. Marshall) introduced the following 
 bill; which was read twice and referred to the Committee on Health, 
 Education, Labor, and Pensions

_______________________________________________________________________

 A BILL

 To provide for health coverage with no cost-sharing for additional 
 breast screenings for certain individuals at greater risk for breast 
 cancer.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Find It Early Act''.

SEC. 2. COVERAGE WITH NO COST-SHARING FOR ADDITIONAL BREAST SCREENINGS 
 FOR CERTAIN INDIVIDUALS AT GREATER RISK FOR BREAST 
 CANCER.

    (a) Coverage Under Group Health Plans and Group and Individual 
Health Insurance Coverage.--

    (1) In general.--

Section 2713

    (a) of the Public Health 
 Service Act (42 U.S.C. 300gg-13

    (a) ) is amended--
        (A) in paragraph

    (2) , by striking ``and'' at the 
 end;
        (B) in paragraph

    (3) , by striking the period at the 
 end and inserting a semicolon;
            (C) in paragraph

    (4) , by striking the period at the 
 end and inserting ``and as described in subparagraph
        (E) ; and'';
            (D) by redesignating paragraphs

    (1) through

    (5) as 
 subparagraphs
        (A) through
        (E) , respectively, and 
 adjusting the margins accordingly;
        (E) by striking the subsection designation and 
 heading and all that follows through ``A group health 
 plan'' and inserting the following:
 ``

    (a) Requirements.--
 ``

    (1) In general.--A group health plan'';
        (F) in the undesignated matter following 
 subparagraph
        (E) of paragraph

    (1) (as so redesignated), 
 by striking ``Nothing in this subsection'' and 
 inserting the following:
 ``

    (3) Rule of construction.--Nothing in this subsection'';
        (G) in subparagraph
        (E) of paragraph

    (1) (as so 
 redesignated), by striking ``
        (E) for the purposes of 
 this Act,'' and inserting the following:
 ``

    (2) Recommendations.--For the purposes of this Act,'';
        (H) in paragraph

    (1) (as so redesignated), by 
 adding at the end the following:
 ``
        (E)
            (i) with respect to an individual who is at 
 increased risk of breast cancer (as determined in 
 accordance with the most recent applicable American 
 College of Radiology Appropriateness Criteria or the 
 most recent applicable guidelines of the National 
 Comprehensive Cancer Network) or with heterogeneously 
 or extremely dense breast tissue (as defined by the 
 Breast Imaging Reporting and Data System established by 
 the American College of Radiology), screening and 
 diagnostic imaging (with no limitation applied on 
 frequency) for the detection of breast cancer, 
 including 2D or 3D mammograms, breast ultrasounds, 
 breast magnetic resonance imaging, molecular breast 
 imaging, or other technologies (as determined in 
 accordance with such applicable criteria or 
 guidelines); and
 ``
            (ii) with respect to an individual who is not 
 described in subparagraph
        (A) and who is determined by 
 a health care provider (in accordance with such most 
 recent applicable criteria or guidelines) to require 
 screening or diagnostic breast imaging by reason of 
 factors, including age, race, ethnicity, or personal or 
 family medical history, screening and diagnostic 
 imaging (with no limitation applied on frequency) for 
 the detection of breast cancer, including 2D or 3D 
 mammograms, breast ultrasounds, breast magnetic 
 resonance imaging, molecular breast imaging, or other 
 technologies (as determined in accordance with such 
 applicable criteria or guidelines).''.

    (2) Effective date.--The amendments made by paragraph

    (1) shall apply with respect to plan years beginning on or after 
 January 1, 2026.

    (3) Application to grandfathered health plans.--

Section 1251

    (a)

    (4)
        (A) of the Patient Protection and Affordable Care Act 
 (42 U.S.C. 18011

    (a)

    (4)
        (A) ) is amended--
        (A) by striking ``title)'' and inserting ``title, 
 or as added after the date of the enactment of this 
 Act)'';
        (B) by redesignating clause
            (iv) as clause
            (v) ; and
            (C) by inserting after clause
            (iii) the following:
 ``
            (iv) Section 2713

    (a)

    (1)
        (E) (relating to 
 screening and diagnostic imaging for the 
 detection of breast cancer).''.

    (b) Coverage Under Medicare.--

    (1) In general.--

Section 1861
            (ddd) (1)
        (B) of the Social 
 Security Act (42 U.S.C. 1395x
            (ddd) (1)
        (B) ) is amended--
        (A) by striking ``
        (B) recommended'' and inserting 
 ``
        (B)
            (i) recommended'';
        (B) by striking ``Task Force; and'' and inserting 
 ``Task Force; or''; and
            (C) by adding at the end the following new clause:
 ``
            (ii) beginning on January 1, 2026, in addition to any 
 other items or services described in this paragraph, screening 
 and diagnostic imaging (with no limitation applied on 
 frequency) for the detection of breast cancer, including 2D or 
 3D mammograms, breast ultrasounds, breast magnetic resonance 
 imaging, molecular breast imaging, or other technologies (as 
 determined in accordance with the most recent applicable 
 American College of Radiology Appropriateness Criteria or the 
 most recent applicable guidelines of the National Comprehensive 
 Cancer Network) for--
 ``
            (I) an individual who is at increased risk of 
 breast cancer (as determined in accordance with such 
 applicable criteria or guidelines) or with 
 heterogeneously or extremely dense breast tissue (as 
 defined by the Breast Imaging Reporting and Data System 
 established by the American College of Radiology); and
 ``
            (II) an individual who is not described in 
 subclause
            (I) and who is determined by a health care 
 provider (in accordance with such most recent 
 applicable criteria or guidelines) to require such 
 screening or diagnostic breast imaging by reason of 
 factors determined by the Secretary, including age, 
 race, ethnicity, or personal or family medical history; 
 and''.

    (2) Application of no cost-sharing under medicare advantage 
 plans.--

Section 1852

    (a)

    (1)
        (B) of the Social Security Act (42 
 U.S.C. 1395w-22

    (a)

    (1)
        (B) ) is amended--
        (A) in clause
            (iv) --
            (i) by redesignating subclause
            (VIII) as 
 subclause
            (IX) ; and
            (ii) by inserting after subclause
            (VII) the 
 following:
 ``
            (VIII) Beginning on January 1, 
 2026, screening and diagnostic imaging 
 and other technologies described in 
 

section 1861
            (ddd) (1)
        (B)
            (ii) furnished 
 to an individual described in such 
 section.''; and
        (B) in clause
            (v) , by striking ``and
            (VI) '' and 
 inserting ``
            (VI) , and
            (VIII) ''.
            (c) Coverage Under Medicaid.--

    (1) In general.--

Section 1905

    (a) of the Social Security Act 
 (42 U.S.C. 1396d

    (a) ) is amended--
        (A) in paragraph

    (4) --
            (i) by striking ``; and
            (D) '' and inserting 
 ``;
            (D) '';
            (ii) by striking ``; and
        (E) '' and 
 inserting ``;
        (E) '';
            (iii) by striking ``; and
        (F) '' and 
 inserting ``;
        (F) ''; and
            (iv) by inserting before the semicolon at 
 the end the following: ``; and
        (G)
            (i) with 
 respect to an individual who is at increased 
 risk of breast cancer (as determined in 
 accordance with the most recent applicable 
 American College of Radiology Appropriateness 
 Criteria or the most recent applicable 
 guidelines of the National Comprehensive Cancer 
 Network) or with heterogeneously or extremely 
 dense breast tissue (as defined by the Breast 
 Imaging Reporting and Data System established 
 by the American College of Radiology), in 
 addition to any other item or service described 
 in this subsection, screening and diagnostic 
 imaging (with no limitation applied on 
 frequency) for the detection of breast cancer, 
 including 2D or 3D mammograms, breast 
 ultrasounds, breast magnetic resonance imaging, 
 molecular breast imaging, or other technologies 
 (as determined in accordance with such 
 applicable criteria or guidelines); and
            (ii) with respect to an individual who is not 
 described in clause
            (i) and who is determined 
 by a health care provider (in accordance with 
 such most recent applicable criteria or 
 guidelines) to require screening or diagnostic 
 breast imaging by reason of factors, including 
 age, race, ethnicity, or personal or family 
 medical history, screening and diagnostic 
 imaging (with no limitation applied on 
 frequency) for the detection of breast cancer, 
 including 2D or 3D mammograms, breast 
 ultrasounds, breast magnetic resonance imaging, 
 molecular breast imaging, or other technologies 
 (as determined in accordance with such 
 applicable criteria or guidelines)''; and
        (B) in paragraph

    (13) , in the matter preceding 
 subparagraph
        (A) , by inserting ``(other than an item or 
 service for which medical assistance is provided 
 pursuant to paragraph

    (4)
        (G) )'' after ``services''.

    (2) No cost-sharing for certain breast cancer screening and 
 diagnostic imaging.--
        (A) In general.--Subsections

    (a)

    (2) and

    (b)

    (2) of 
 

section 1916 of the Social Security Act (42 U.S.C. 
 1396o) are each amended--
            (i) in subparagraph
            (I) , by striking ``or'' 
 at the end;
            (ii) in subparagraph
        (J) , by striking at 
 the end ``; and'' and inserting ``, or''; and
            (iii) by adding at the end the following 
 subparagraph:
 ``
        (K) with respect to an individual described in 
 clause
            (i) or
            (ii) of 

section 1905

    (a)

    (4)
        (G) , screening 
 and diagnostic imaging and other technologies described 
 in such clause
            (i) or
            (ii) , respectively; and''.
        (B) Application to alternative cost-sharing.--
 

Section 1916A

    (b)

    (3)
        (B) of the Social Security Act (42 
 U.S.C. 1396o-1

    (b)

    (3)
        (B) ) is amended by adding at the 
 end the following new clause:
 ``
            (xv) With respect to an individual 
 described in clause
            (i) or
            (ii) of 

section 1905

    (a)

    (4)
        (G) , screening and diagnostic imaging 
 and other technologies described in such clause
            (i) or
            (ii) , respectively.''.

    (3) Inclusion in benchmark coverage.--

Section 1937

    (b) of 
 the Social Security Act (42 U.S.C. 1396u-7

    (b) ) is amended by 
 adding at the end the following new paragraph:
 ``

    (9) Coverage of certain breast cancer screening and 
 diagnostic imaging for certain individuals.--Notwithstanding 
 the previous provisions of this section, a State may not 
 provide for medical assistance through enrollment of an 
 individual with benchmark coverage or benchmark-equivalent 
 coverage under this section unless such coverage includes 
 medical assistance, with respect to an individual described in 
 clause
            (i) or
            (ii) of 

section 1905

    (a)

    (4)
        (G) , for screening and 
 diagnostic imaging and other technologies described in such 
 clause
            (i) or
            (ii) , respectively.''.

    (4) Effective date.--
        (A) In general.--Except as provided in subparagraph
        (B) , the amendments made by this subsection shall take 
 effect on January 1, 2026.
        (B) Delay permitted if state legislation 
 required.--In the case of a State plan approved under 
 title XIX of the Social Security Act which the 
 Secretary of Health and Human Services determines 
 requires State legislation (other than legislation 
 appropriating funds) in order for the plan to meet the 
 additional requirements imposed by this section, the 
 State plan shall not be regarded as failing to comply 
 with the requirements of such title solely on the basis 
 of the failure of the plan to meet such additional 
 requirements before the first day of the first calendar 
 quarter beginning after the close of the first regular 
 session of the State legislature that ends after the 1-
 year period beginning with the date of the enactment of 
 this section. For purposes of the preceding sentence, 
 in the case of a State that has a 2-year legislative 
 session, each year of the session is deemed to be a 
 separate regular session of the State legislature.
            (d) Coverage and Elimination of Cost-Sharing Under TRICARE.--

    (1) Coverage.--Title 10, United States Code, is amended--
        (A) in 

section 1074d

    (a) , by adding at the end the 
 following new paragraph:
 ``

    (3) Any member or former member of the uniformed services who is 
entitled to medical care under 

section 1074 or 1074a of this title and 
is an individual described in subparagraph
        (B) of 

section 1079

    (a)

    (20) of this title shall also be entitled to the items and services 
described in subparagraph
        (A) of such section (subject to the same 
limitations specified in such subparagraph), as part of such medical 
care.''; and
        (B) in 

section 1079

    (a) , by adding at the end the 
 following new paragraph:
 ``

    (20)
        (A) Screening and diagnostic imaging (with no 
 limitation applied on frequency) for the detection of breast 
 cancer, including 2D or 3D mammograms, breast ultrasounds, 
 breast magnetic resonance imaging, molecular breast imaging, or 
 other technologies (as determined in accordance with the most 
 recent applicable criteria or guidelines described in 
 subparagraph
        (B) ), shall be provided if the patient is an 
 individual described in subparagraph
        (B) .
 ``
        (B) An individual described in this subparagraph is--
 ``
            (i) an individual who is at increased risk of 
 breast cancer (as determined in accordance with the 
 most recent applicable American College of Radiology 
 Appropriateness Criteria or the most recent applicable 
 guidelines of the National Comprehensive Cancer 
 Network) or with heterogeneously or extremely dense 
 breast tissue (as defined by the Breast Imaging 
 Reporting and Data System established by the American 
 College of Radiology); or
 ``
            (ii) an individual who is not described in clause
            (i) and who is determined by a health care provider (in 
 accordance with such most recent applicable criteria or 
 guidelines) to require screening or diagnostic breast 
 imaging by reason of factors including age, race, 
 ethnicity, or personal or family medical history.''.

    (2) Elimination of cost-sharing.--Such title is further 
 amended--
        (A) in 

section 1075a, by adding at the end the 
 following new subsection:
 ``
            (d) Elimination of Cost-Sharing for Certain Breast Cancer-Related 
Items and Services.--Notwithstanding any other provision of this 
section, cost-sharing requirements may not be imposed or collected with 
respect to any beneficiary enrolled in TRICARE Prime for any item or 
service described in subparagraph
        (A) of 

section 1079

    (a)

    (20) of this 
title provided under TRICARE Prime, in accordance with the limitations 
specified in such subparagraph, if the beneficiary is an individual 
described in subparagraph
        (B) of such section.'';
        (B) in 

section 1075
            (c) , by adding at the end the 
 following new paragraph:
 ``

    (5) Notwithstanding any other provision of this section, 
 cost-sharing requirements may not be imposed or collected with 
 respect to any beneficiary enrolled in TRICARE Select for any 
 item or service described in subparagraph
        (A) of 

section 1079

    (a)

    (20) of this title provided under TRICARE Select, in 
 accordance with the limitations specified in such subparagraph, 
 if the beneficiary is an individual described in subparagraph
        (B) of such section.''; and
            (C) in 

section 1086, by adding at the end the 
 following new subsection:
 ``

    (j) Notwithstanding any other provision of this section, cost-
sharing may not be imposed or collected under a plan contracted for 
under subsection

    (a) with respect to any individual described in 
subparagraph
        (B) of 

section 1079

    (a)

    (20) of this title for an item or 
service described in subparagraph
        (A) of such section and provided in 
accordance with the limitations specified in such subparagraph.''.

    (3) Effective date.--The amendments made by this subsection 
 shall take effect on January 1, 2026.

    (e) Coverage and Elimination of Cost-Sharing With Respect to 
Veterans.--

    (1) Coverage and elimination of cost-sharing.--Subchapter 
 II of chapter 17 of title 38, United States Code, is amended by 
 inserting after 

section 1720J the following new section:
``

Sec. 1720K. Breast screenings for certain individuals at increased 
 risk for breast cancer
 ``

    (a) Coverage of Items and Services.--
 ``

    (1) Coverage.--The Secretary shall furnish to a veteran 
 described in paragraph

    (2) screening and diagnostic imaging 
 (with no limitation applied on frequency) for the detection of 
 breast cancer, including 2D or 3D mammograms, breast 
 ultrasounds, breast magnetic resonance imaging, molecular 
 breast imaging, or other technologies (as determined in 
 accordance with the most recent applicable criteria or 
 guidelines described in such paragraph) pursuant to this 
 section.
 ``

    (2) Eligibility.--A veteran described in this paragraph 
 is--
 ``
        (A) a veteran who is at increased risk of breast 
 cancer (as determined in accordance with the most 
 recent applicable American College of Radiology 
 Appropriateness Criteria or the most recent applicable 
 guidelines of the National Comprehensive Cancer 
 Network) or with heterogeneously or extremely dense 
 breast tissue (as defined by the Breast Imaging 
 Reporting and Data System established by the American 
 College of Radiology), without regard to whether the 
 veteran is enrolled in the system of annual patient 
 enrollment established and operated under 

section 1705

    (a) of this title; or
 ``
        (B) a veteran who is not described in 
 subparagraph
        (A) and who is determined by a health care 
 provider (in accordance with such most recent 
 applicable criteria or guidelines) to require screening 
 or diagnostic breast imaging by reason of factors 
 including age, race, ethnicity, or personal or family 
 medical history, without regard to whether the veteran 
 is enrolled in the system of annual patient enrollment 
 established and operated under 

section 1705

    (a) of this 
 title.
 ``

    (b) Prohibition on Cost-Sharing.--Notwithstanding subsections

    (f) and

    (g) of 

section 1710 and 

section 1722A of this title, the Secretary 
may not require any veteran described in paragraph

    (2) of subsection

    (a) to make any copayment for, or charge the veteran for any other cost 
of, the receipt of any item or service furnished pursuant to paragraph

    (1) of such subsection.''.

    (2) Clerical amendment.--The table of sections at the 
 beginning of such chapter is amended by inserting after the 
 item relating to 

section 1720J the following new item:

``1720K. Breast screenings for certain individuals at increased risk 
 for breast cancer.''.

    (3) Effective date.--The amendments made by this subsection 
 shall take effect on January 1, 2026.
 <all>