[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 Network to an individual 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) 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.''.
(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 for screening and diagnostic imaging and
other technologies described in clause (i) or (ii) of section
1904(a)(4)(G) furnished at such frequency as is recommended in
guidelines set forth by the National Comprehensive Cancer
Network to an individual 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:
``(21)(A) 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 criteria or guidelines described in
subparagraph (B)), shall be provided at such frequency as is
recommended in guidelines set forth by the National
Comprehensive Cancer Network 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:
``(e) 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:
``(4) 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 1720L the following new section:
``Sec. 1720M. 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 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 criteria or guidelines described in such
paragraph) at such frequency as is recommended in guidelines
set forth by the National Comprehensive Cancer Network 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:
``1720M. 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.
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