Coverage under Medicare and private health insurance of annual lung cancer screening without utilization management requirements

(a) Medicare (1) In general Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection: (z) Special rule for annual lung cancer screening Notwithstanding any other provision of this title, in the case of an annual lung cancer screening for which benefits are provided under this part for any individual for whom such screening is recommended in accordance with guidelines issued by the Secretary, such benefits shall be provided without application of any prior authorization.. (2) Application under Medicare Advantage Section 1852(a)(1)(B) of the Social Security Act (42 U.S.C. 1395w–22(a)(1)(B)) is amended by adding at the end the following new clause: (vii) Prohibition of application of certain requirements for annual lung cancer screening In the case of an annual lung cancer screening for which benefits are provided under part B for any individual for whom such screening is recommended in accordance with guidelines issued by the Secretary for purposes of section 1834(z), an MA plan may not impose any prior authorization with respect to the coverage of such screening under such plan.. (3) Effective date The amendments made by this subsection shall apply with respect to services furnished on or after January 1, 2026. (b) Individual and group health insurance markets (1) In general Section 2713 of the Public Health Service Act (42 U.S.C. 300gg–(3)) is amended by adding at the end the following new subsection: (d) Prohibition of application of certain requirements for annual lung cancer screening A group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any prior authorization with respect to the benefits under such plan or coverage for an annual lung cancer screening for any individual for whom such screening is recommended by the United States Preventive Services Task Force.. (2) Effective date The amendments made by this subsection shall apply with respect to plan years beginning on or after January 1, 2026.