[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8260 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 8260
To amend title XXVII of the Public Health Service Act and titles XVIII
and XIX of the Social Security Act to require coverage of certain
cardiovascular tests without cost sharing under group health plans,
group and individual health insurance coverage, and the Medicare and
Medicaid programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 14, 2026
Mrs. Cherfilus-McCormick introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committee on Ways and Means, 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 amend title XXVII of the Public Health Service Act and titles XVIII
and XIX of the Social Security Act to require coverage of certain
cardiovascular tests without cost sharing under group health plans,
group and individual health insurance coverage, and the Medicare and
Medicaid programs.
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 ``Cardiovascular Disease Early
Detection and Prevention Act of 2026''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Cardiovascular disease is the leading cause of death in
the United States.
(2) Routine cholesterol panels often fail to detect
elevated Lipoprotein(a) (Lp(a)) and Apolipoprotein B (ApoB)
levels.
(3) Approximately 1 in 5 Americans have elevated Lp(a)
levels.
(4) Elevated ApoB levels predict cardiovascular risk better
than LDL cholesterol alone.
(5) Nearly 50 percent of heart attack survivors die within
five years without effective risk management.
SEC. 3. REQUIRING COVERAGE OF CERTAIN CARDIOVASCULAR TESTS WITHOUT COST
SHARING UNDER GROUP HEALTH PLANS, GROUP AND INDIVIDUAL
HEALTH INSURANCE COVERAGE, AND THE MEDICARE AND MEDICAID
PROGRAMS.
(a) Public Health Service Act.--Section 2713(a) of the Public
Health Service Act (42 U.S.C. 300gg-13(a)) is amended--
(1) in paragraph (2), by striking ``and'' at the end;
(2) in paragraph (3), by striking the period and inserting
a semicolon;
(3) by redesignating paragraphs (4) and (5) as paragraphs
(5) and (6), respectively; and
(4) by inserting after paragraph (3) the following new
paragraph:
``(4) with respect to individuals with a family history of
premature cardiovascular disease, a personal history of
myocardial infarction, stroke, or elevated LDL cholesterol, a
diagnosis of diabetes mellitus or obesity, or other recognized
cardiovascular risk factors, testing for lipoprotein(a) and
apolipoprotein B levels; and''.
(b) Medicare.--
(1) In general.--Section 1861(xx)(1) of the Social Security
Act (42 U.S.C. 1395x(xx)(1)) is amended--
(A) by redesignating subparagraph (B) as
subparagraph (C);
(B) by inserting after subparagraph (A) the
following new subparagraph:
``(B) In the case of an individual with a family history of
premature cardiovascular disease, a personal history of
myocardial infarction, stroke, or elevated LDL cholesterol, a
diagnosis of diabetes mellitus or obesity, or other recognized
cardiovascular risk factors, lipoprotein(a) and apolipoprotein
B levels.''; and
(C) in the flush matter at the end, by striking
``subparagraph (B)'' and inserting ``subparagraph
(C)''.
(2) No application of cost sharing.--Section 1833 of the
Social Security Act (42 U.S.C. 1395l) is amended--
(A) in subsection (a)(1)(Y), by inserting ``(other
than tests for levels described in section
1861(ww)(1)(B) furnished to an individual described in
such section)'' after ``described in subparagraph
(A)''; and
(B) in subsection (b)(1), by striking ``for the
individual.'' inserting ``for the individual or that
are tests for levels described in section
1861(ww)(1)(B) furnished to an individual described in
such section''.
(c) Medicaid.--
(1) In general.--Section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) is amended--
(A) in paragraph (31), by striking ``and'' at the
end;
(B) by redesignating paragraph (32) as paragraph
(33); and
(C) by inserting after paragraph (31) the following
new paragraph:
``(32) testing for lipoprotein(a) and apolipoprotein B
levels furnished to an individual with a family history of
premature cardiovascular disease, a personal history of
myocardial infarction, stroke, or elevated LDL cholesterol, a
diagnosis of diabetes mellitus or obesity, or other recognized
cardiovascular risk factors; and''.
(2) No cost sharing.--
(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 ``;
and'' and inserting ``, or''; and
(iii) by adding at the end the following
new subparagraph:
``(K) testing for lipoprotein(a) and apolipoprotein
B levels furnished to an individual described in
section 1905(a)(32); 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) Testing for lipoprotein(a) and
apolipoprotein B levels furnished to an
individual described in section 1905(a)(32).''.
(3) Mandatory coverage.--Section 1902(a)(10)(A) of the
Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by
striking ``and (30)'' and inserting ``(30), and (32)''.
(4) Benchmark coverage and benchmark-equivalent 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 lipid level testing.--
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
provides, with respect to an individual described in section
1905(a)(32), testing for lipoprotein(a) and apolipoprotein B
levels.''.
(d) Effective Date.--The amendments made by--
(1) subsection (a) shall apply with respect to plan years
beginning on or after the date that is 180 days after the date
of the enactment of this Act; and
(2) subsections (b) and (c) shall apply with respect to
items and services and medical assistance, respectively,
furnished on or after such date.
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