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Bill

HR 6320

To amend title XIX of the Social Security Act to require coverage of lung cancer biomarker testing under the Medicaid program.

119th Congress Introduced by Josh Gottheimer and 1 co-sponsor

Requires Medicaid to cover lung cancer biomarker testing as part of diagnostic evaluation and treatment planning for enrollees with suspected or diagnosed lung cancer.

Introduced in House
2
WeVote Research Nonpartisan
Bill Summary · HR 6320

Summary of HR 6320

Overview

HR 6320 is a proposed federal bill introduced in the House on November 28, 2025. The bill would amend Title XIX of the Social Security Act to require Medicaid programs to cover lung cancer biomarker testing. Upon introduction, it was referred to the House Committee on Energy and Commerce.

What the bill would do

  • Amend Title XIX (Medicaid) to require coverage of lung cancer biomarker testing.
  • Establish that such testing must be included as part of Medicaid coverage for lung cancer-related diagnostic evaluation and treatment planning, aligning Medicaid benefits with standard medical practice for lung cancer care.

Key Provisions (as indicated by the bill’s title and introduction)

  • Mandatory coverage: Requires Medicaid programs to cover biomarker testing used to inform lung cancer treatment decisions.
  • Scope: Coverage would apply under the Medicaid program for individuals diagnosed with or being evaluated for lung cancer.
  • Implementation: The exact administrative details, covered tests, and criteria would be defined in the statutory language of Title XIX as amended, subject to how the bill is drafted and interpreted by implementing agencies.

Who would be affected

  • Medicaid enrollees diagnosed with or suspected of having lung cancer.
  • State Medicaid programs, which administer the coverage at the federal/state level.
  • Healthcare providers and laboratories performing lung cancer biomarker testing, who would seek reimbursement under Medicaid.
  • Clinicians who rely on biomarker test results to guide targeted therapies and treatment planning.

Legislative status and process

  • Introduced in the U.S. House of Representatives on November 28, 2025.
  • Referred to the House Committee on Energy and Commerce on the same day.
  • No additional actions (e.g., committee reports or floor votes) are listed in the provided information.

Potential impacts and considerations

  • Access and equity: Could improve access to essential diagnostic testing for lower-income individuals enrolled in Medicaid, potentially enabling more informed treatment decisions.
  • Alignment with care standards: Would bring Medicaid benefits more in line with contemporary lung cancer care that relies on biomarker testing to guide targeted therapies.
  • Fiscal effects: Specific budgetary implications are not provided; implementation could affect Medicaid expenditures related to diagnostic testing, depending on enumeration of covered tests and any associated cost-sharing or utilization controls.
  • Implementation details: The precise list of covered tests, medical necessity criteria, and any limitations would be defined in the amended Title XIX language and accompanying regulatory guidance.

If you’d like, I can add a brief, plain-language comparison to current Medicaid coverage for biomarker testing (based on available guidelines) or draft a checklist of questions to ask a committee staffer about anticipated implementation details.

Compiled from official sources — confirm details with the bill’s official record.

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