Access to Genetic Counselor Services Act of 2025
Summary
The Access to Genetic Counselor Services Act of 2025 aims to amend Title XVIII of the Social Security Act, expanding Medicare coverage to include services provided by genetic counselors under Part B. This expansion would allow Medicare beneficiaries to access genetic counseling services, potentially improving preventative care and personalized medicine. The bill also addresses payment structures and balance billing for these services.
Expected Effects
This act would enable Medicare to cover genetic counseling services furnished by qualified genetic counselors, starting January 1, 2027. It would also set payment rates for these services at 80% of the lesser of the actual charge or 85% of the physician fee schedule. The bill aims to improve access to genetic counseling for Medicare beneficiaries.
Potential Benefits
- Increased access to genetic counseling services for Medicare beneficiaries.
- Potential for earlier detection and prevention of genetic diseases.
- Improved personalized medicine approaches based on genetic information.
- Recognition of genetic counselors as healthcare providers under Medicare.
- May lead to better health outcomes and reduced healthcare costs in the long term.
Most Benefited Areas:
Potential Disadvantages
- Increased Medicare spending, although potentially offset by preventative care benefits.
- Potential for increased demand for genetic counseling services, possibly straining the existing workforce.
- Implementation challenges for the Secretary of Health and Human Services.
- Possible confusion or overlap with existing genetic counseling services provided by physicians.
- The 85% fee schedule may disincentivize genetic counselors from participating in Medicare.
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution, as it aims to improve healthcare access for a specific population (Medicare beneficiaries). Specifically, the preamble states the Constitution is intended to "promote the general Welfare". The expansion of Medicare benefits falls under Congress's power to legislate on matters related to healthcare and social security. Article I, Section 8 grants Congress the power to lay and collect taxes to provide for the general welfare of the United States.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).