Hereditary cancer genetic testing of individuals with a family history of a hereditary cancer gene mutation or personal or family history suspicious for hereditary cancer

(a) Coverage Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended— (1) in subsection (s)(2)— (A) in subparagraph (JJ), by inserting and at the end; and (B) by adding at the end the following new subparagraph: (KK) in the case of an individual with a personal or family history of a hereditary cancer gene mutation or a personal or family history suspicious for hereditary cancer, germline mutation testing;; and (2) by adding at the end the following new subsection: (nnn) Germline mutation testing The term germline mutation testing means genetic testing for germline mutations that is in accordance with evidence-based, clinical practice guidelines specifically addressing genetic testing, screening, and management of individuals with inherited mutations associated with increased cancer risk that— (1) have been developed by a nationally recognized oncology professional organization, including the National Comprehensive Cancer Network, the American Society of Clinical Oncology, the Society of Gynecologic Oncology, or any other oncology professional organization specified by a medicare administrative contractor with a contract under section 1874A; and (2) in the case of conflicting guidelines developed by more than one nationally recognized oncology professional organization, are the least restrictive of such guidelines, as determined by such a medicare administrative contractor.. (b) Frequency Section 1862(a)(1) of the Social Security Act (42 U.S.C. 1395y(a)(1)) is amended— (1) by striking and at the end of subparagraph (O); (2) by adding and at the end of subparagraph (P); and (3) by adding at the end the following new subparagraph: (Q) in the case of germline mutation testing as defined in section 1861(nnn), which is performed more than once with respect to an individual described in such section;. (c) Effective date The amendments made by this section shall apply to testing furnished on or after the date of the enactment of this Act.