About the Bill

about H.R. 3235

H.R. 3235 takes a measured approach to modernize Medicare to catch up with the innovation of genetics and genomic medicine.

The bill would improve the ability of other practitioners, such as physicians, to refer patients for genetic counseling to genetic counselors under Medicare Part B, provide reimbursement to genetic counselors at 85% of the physician fee schedule amount, and ensure that other practitioners that currently provide the service can continue to do so if the activities are within their scope of practice.

What will this change?

Genetic counselors are board-certified health care providers and should be recognized as such by the US Centers for Medicare & Medicaid Services (CMS). This recognition will result in:

Increased access

to genetic counseling services for up to 60 million medicare beneficiaries.

Cost

savings

1. Increased appropriateness of genetic tests is projected to save up to $4 billion to CMS/Medicare over ten years
2. Independent billing by genetic counselors at 85% the rate of MDs is projected to save CMS $50-135 million dollars over ten years.

Decreased

wait-times:

With genetic counselors able to see the appropriate patients independently, current appointment wait times in specific specialties will decrease.

Decreased Fraud

A recent genetic testing fraud cost Medicare >$2B. Genetic counselors are well equipped to recognize this type of fraudulent activity as they know the guidelines and have the detective skills to investigate.