The PREFERRED Screening Act establishes a Medicare payment model to provide eligible individuals with comprehensive breast cancer risk assessments and personalized screening and risk-reduction plans.
Bill Cassidy
Senator
LA
The PREFERRED Screening Act directs the Secretary of Health and Human Services to implement a Medicare payment model that incentivizes providers to offer comprehensive, personalized breast cancer risk assessments. By integrating genetic testing, family history, and clinical data, the program aims to provide tailored screening and risk-reduction plans for Medicare beneficiaries. This initiative prioritizes underserved and high-risk populations to improve early detection and evaluate the long-term effectiveness of risk-stratified breast cancer care.
Medicare to Launch Personalized Breast Cancer Risk Program: Genetic Testing and Custom Screening Plans Starting Within Two Years.
The PREFERRED Screening Act introduces a new Medicare payment model designed to move away from one-size-fits-all breast cancer screening. Instead of just a standard annual mammogram, this bill requires the government to pay doctors and specialists to perform deep-dive risk assessments for patients aged 40 to 74. These assessments will pull together your genetic test results—looking at specific genes like BRCA1 and PALB2—along with your family history, breast density, and even lifestyle habits. The goal is to give you a personalized roadmap that tells you exactly how often you should be screened and whether you need advanced imaging like an MRI rather than just a standard mammogram.
Your DNA, Your Schedule
Under this plan, the assessment isn't just a quick chat; it’s a data-heavy evaluation. If you’re a 45-year-old teacher with a family history of cancer, your doctor would use a validated risk model to place you into a 'high-risk' or 'elevated-risk' category. From there, you get a personalized screening and risk-reduction plan. This could include referrals for enhanced surveillance imaging, counseling on medications like tamoxifen, and even advice on modifiable factors like alcohol consumption and weight management. The bill specifically allows for these assessments to happen in person or via remote kits mailed to your home, making it easier for people with tight work schedules to get tested. (Section 2, Comprehensive Risk Assessments).
Prioritizing the Gaps
The rollout of this program isn't random. The bill directs the Secretary of Health and Human Services to prioritize doctors in the 10 states with the highest breast cancer mortality rates and those working in rural or medically underserved areas. This is a big deal for someone living in a small town who currently has to drive three hours to see a genetic counselor. By reimbursing a wider range of professionals—including physician assistants and certified genetic counselors—the bill aims to build a network that can actually handle the demand in places where specialists are currently scarce. (Section 2, Delivery Methods and Participating Providers).
The Fine Print and the Exclusions
While this looks like a major upgrade for preventive care, there are some notable speed bumps. First, if you’re on a Medicare Advantage plan, you’re currently left out of this specific test run; it’s only for those on traditional Medicare Part A and B. Second, the bill gives the Secretary a lot of 'vague authority' to decide which genetic tests count and which health professionals are 'qualified' to get paid. There’s also the reality that while the assessment is covered, the bill doesn't explicitly guarantee that every follow-up treatment or specialized MRI recommended in your plan will be fully covered without out-of-pocket costs. Finally, the program is set as a seven-year test, meaning its long-term survival depends on whether the data shows it actually saves lives and money. (Section 2, Evaluation Measures and Definitions).