[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6182 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 6182
To provide for health coverage with no cost-sharing for additional
breast screenings for certain individuals at greater risk for breast
cancer.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 20, 2025
Ms. DeLauro (for herself, Mr. Fitzpatrick, Mr. Murphy, Mr. Landsman,
Mrs. Beatty, Ms. Velazquez, Ms. Simon, Mr. Doggett, Mr. Quigley, Mr.
Nadler, Mr. Tonko, Mr. Larson of Connecticut, Ms. Houlahan, Mr.
Schneider, Ms. Scholten, Ms. Sewell, Mr. Casten, Ms. Chu, Mr.
Bresnahan, Mr. Pocan, Ms. Schakowsky, Ms. Castor of Florida, Mr.
Goldman of New York, Mrs. Hayes, Ms. Matsui, Ms. Jayapal, Mr. Lawler,
Mr. Gottheimer, Mr. Bishop, Mrs. Watson Coleman, Mr. Cohen, Ms. Norton,
Ms. Lee of Pennsylvania, Ms. Van Duyne, Mr. Costa, Ms. Wasserman
Schultz, Mrs. McClain Delaney, Ms. Stevens, Mr. Himes, Mr. Thanedar,
Mrs. Trahan, and Mr. Deluzio) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committees on Ways and Means, Education and Workforce, Armed
Services, and Veterans' Affairs, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
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) PHSA.--
(A) In general.--Part D of title XXVII of the
Public Health Service Act (42 U.S.C. 300gg-111 et seq.)
is amended by adding at the end the following new
section:
``SEC. 2799A-11. COVERAGE OF BREAST SCREENINGS FOR CERTAIN INDIVIDUALS
AT INCREASED RISK FOR BREAST CANCER.
``With respect to plan years beginning on or after anuary 1, 2026,
a group health plan or health insurance issuer offering group or
individual health insurance coverage shall provide coverage and shall
not impose any cost sharing requirements for--
``(1) 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 for the detection of breast cancer,
including 2D or 3D mammograms, breast ultrasounds, breast
magnetic resonance imaging, molecular breast imaging, contrast-
enhanced mammography, or other technologies (as determined in
accordance with such applicable criteria or guidelines),
furnished at such frequency as is recommended in guidelines set
forth by the National Comprehensive Cancer Network; and
``(2) with respect to an individual who is not described in
paragraph (1) 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 for the detection of breast cancer, including 2D or 3D
mammograms, breast ultrasounds, breast magnetic resonance
imaging, molecular breast imaging, contrast-enhanced
mammography, or other technologies (as determined in accordance
with such applicable criteria or guidelines), furnished at such
frequency as is recommended in guidelines set forth by the
National Comprehensive Cancer Network.''.
(B) Application to grandfathered health plans.--
Section 1251(a)(5) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18011(a)(5)) is amended
by inserting ``, and section 2799A-11 of such Act shall
apply to grandfathered health plans for plan years
beginning on or after January 1, 2026'' after ``January
1, 2022''.
(2) ERISA.--
(A) In general.--Subpart B of part 7 of subtitle B
of title I of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1185 et seq.) is amended by
adding at the end the following new section:
``SEC. 726. COVERAGE OF BREAST SCREENINGS FOR CERTAIN INDIVIDUALS AT
INCREASED RISK FOR BREAST CANCER.
``With respect to plan years beginning on or after January 1, 2026,
a group health plan or health insurance issuer offering group health
insurance coverage shall provide coverage and shall not impose any cost
sharing requirements for--
``(1) 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 for the detection of breast cancer,
including 2D or 3D mammograms, breast ultrasounds, breast
magnetic resonance imaging, molecular breast imaging, contrast-
enhanced mammography, or other technologies (as determined in
accordance with such applicable criteria or guidelines),
furnished at such frequency as is recommended in guidelines set
forth by the National Comprehensive Cancer Network; and
``(2) with respect to an individual who is not described in
paragraph (1) 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 for the detection of breast cancer, including 2D or 3D
mammograms, breast ultrasounds, breast magnetic resonance
imaging, molecular breast imaging, contrast-enhanced
mammography, or other technologies (as determined in accordance
with such applicable criteria or guidelines), furnished at such
frequency as is recommended in guidelines set forth by the
National Comprehensive Cancer Network.''.
(B) Clerical amendment.--The table of contents in
section 1 of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1001 note) is amended by
inserting after the item relating to section 725 the
following new item:
``Sec. 726. Coverage of breast screenings for certain individuals at
increased risk for breast cancer.''.
(3) IRC.--
(A) In general.--Subchapter B of chapter 100 of the
Internal Revenue Code of 1986 is amended by adding at
the end the following new section:
``SEC. 9826. COVERAGE OF BREAST SCREENINGS FOR CERTAIN INDIVIDUALS AT
INCREASED RISK FOR BREAST CANCER.
``With respect to plan years beginning on or after January 1, 2026,
a group health plan shall provide coverage and shall not impose any
cost sharing requirements for--
``(1) 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 for the detection of breast cancer,
including 2D or 3D mammograms, breast ultrasounds, breast
magnetic resonance imaging, molecular breast imaging, contrast-
enhanced mammography, or other technologies (as determined in
accordance with such applicable criteria or guidelines),
furnished at such frequency as is recommended in guidelines set
forth by the National Comprehensive Cancer Network; and
``(2) with respect to an individual who is not described in
paragraph (1) 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 for the detection of breast cancer, including 2D or 3D
mammograms, breast ultrasounds, breast magnetic resonance
imaging, molecular breast imaging, contrast-enhanced
mammography, or other technologies (as determined in accordance
with such applicable criteria or guidelines), furnished at such
frequency as is recommended in guidelines set forth by the
National Comprehensive Cancer Network.''.
(B) Clerical amendment.--The table of sections for
subchapter B of chapter 100 of such Code is amended by
adding at the end the following new item:
``Sec. 9826. Coverage of breast screenings for certain individuals at
increased risk for 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) with respect services furnished on or after January
1, 2026, screening and diagnostic imaging for the detection of
breast cancer, including 2D or 3D mammograms, breast
ultrasounds, breast magnetic resonance imaging, molecular
breast imaging, contrast-enhanced mammography, 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), furnished not more
frequently than is recommended in guidelines set forth by the
National Comprehensive Cancer Network to--
``(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); or
``(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
not more frequently than is recommended
in guidelines set forth by the National
Comprehensive Cancer Network 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 for the detection of breast cancer,
including 2D or 3D mammograms, breast
ultrasounds, breast magnetic resonance imaging,
molecular breast imaging, contrast-enhanced
mammography, or other technologies (as
determined in accordance with such applicable
criteria or guidelines) furnished not more
frequently than is recommended in guidelines
set forth by the National Comprehensive Cancer
Network; 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 for the detection of breast
cancer, including 2D or 3D mammograms, breast
ultrasounds, breast magnetic resonance imaging,
molecular breast imaging, contrast-enhanced
mammography, or other technologies (as
determined in accordance with such applicable
criteria or guidelines) furnished not more
frequently than is recommended in guidelines
set forth by the National Comprehensive Cancer
Network''; 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.--Section 1916 of the Social
Security Act (42 U.S.C. 1396o) is amended--
(i) in subsection (a)(2)--
(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) screening and diagnostic imaging and other
technologies described in clause (i) or (ii) of section
1904(a)(4)(G) furnished not more frequently than is
recommended in guidelines set forth by the National
Comprehensive Cancer Network to an individual described
in such clause (i) or (ii), respectively; and''; and
(ii) in subsection (b)(2)--
(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) screening and diagnostic imaging and other
technologies described in clause (i) or (ii) of section
1904(a)(4)(G) furnished not more frequently than is
recommended in guidelines set forth by the National
Comprehensive Cancer Netw