S. 4566 — Increasing Access to Lung Cancer Screening Act

This section requires states to cover annual lung cancer screening under Medicaid for eligible individuals when recommended by United States Preventive Services Task Force guidelines (as published March 9, 2021), without cost sharing or prior authorization. It applies to services furnished on or after January 1, 2028, and requires the same coverage from Medicaid managed care organizations.

This section expands Medicaid coverage of counseling and pharmacotherapy for cessation of tobacco use to all enrollees (from only pregnant women), prohibits prior authorization, eliminates cost sharing, and includes use of e-cigarettes and vape pens. The changes apply to items and services furnished on or after January 1, 2028, and require Medicaid managed care organizations to provide the coverage.

This section prohibits prior authorization requirements for annual lung cancer screening under Medicare Part B and Medicare Advantage plans for individuals recommended for screening under Secretary guidelines, effective for services furnished on or after January 1, 2028. It also bars group health plans and issuers of individual or group coverage from imposing prior authorization on such screening when recommended by the United States Preventive Services Task Force, effective for plan years beginning on or after January 1, 2028.

This section directs the Secretary of Health and Human Services, in consultation with patient and lung cancer advocacy groups, to conduct an education and outreach campaign informing individuals and health care providers of the importance of lung cancer screenings and the categories of individuals who should receive them. The campaign must target individuals at high risk of lung cancer and is authorized at $10 million annually for fiscal years 2028 through 2032.

This section directs the Comptroller General to conduct a study and submit a report to Congress within one year on the demographics of individuals diagnosed with lung cancer and those screened for it. The report must identify population segments diagnosed but excluded from current screening eligibility guidelines, such as firefighters, veterans, and women under 50 years of age, and recommend federal actions to improve screening for those groups.