Medicare Multi-Cancer Early Detection Screening Coverage (MCED) Act

The Act for Multi-Cancer Early Detection (MCED) could broaden access to cancer screenings under Medicare. This legislation would enable Medicare to cover multi-cancer early detection tests once they receive FDA approval and demonstrate clinical benefits. Right now, this House bill has 314 cosponsors and 62 cosponsors in the Senate.

According to the American Cancer Society, CMS will establish its coverage criteria (based on the updated language) using an evidence-based approach. The bill clarifies that Medicare's coverage of MCED tests will not interfere with its coverage of other screening methods. These new tests will enhance—rather than replace—Medicare’s current cancer screening coverage. While the bill grants CMS the authority to define coverage parameters, it does not require CMS to cover particular tests. Without this legislation, Medicare beneficiaries may face significant delays in accessing multi-cancer early detection.

Implementation Date: The updated legislation specifies that CMS cannot begin covering MCED tests until 2028, aligning with the expected timeline for FDA approval of these tests.

Phase-in Eligibility: The legislation introduces a phased approach to coverage for MCED tests, which will include age criteria for evidence-based cancer screenings. According to the American Cancer Society, starting January 1, 2028, Medicare could cover MCED tests for individuals aged 65 to 70. Each following year, the coverage will expand by one year, allowing for coverage of individuals aged 65 to 71 in 2029. This gradual rollout prioritizes the majority of Medicare beneficiaries, as half of them are aged 65 to 74.

Payment Rate: The revised legislation sets the Medicare payment rate for MCED tests equal to the rate for multi-target stool DNA tests at the time the legislation is enacted. Discussions with the House Budget Committee suggest that this revised legislation could result in a Congressional Budget Office (CBO) score of approximately $4.3 billion over the next ten years.

Cancer mortality rates in the United States have been decreasing for over twenty years; however, disparities based on race, financial status, and geography still exist. Multi-cancer screening tests could help reduce these disparities by enabling earlier detection of cancers in a larger number of people.

ACS CAN supports the Medicare Multi-Cancer Early Detection Screening. (2024, June 26). American Cancer Society Cancer Action Network. https://www.fightcancer.org/po...