Bill S.847 194th (Current)

This bill mandates that Medicaid provides rapid whole genome sequencing as a separately payable service for specific beneficiaries, subject to defined criteria. It specifies that this genomic sequencing, which includes both coding and non-coding regions of the human genome, must deliver preliminary results within five days and complete results within fourteen days. The service targets Medicaid beneficiaries who are 21 years or younger, hospitalized in intensive care units or high-acuity pediatric units, and suffering from complex or acute illnesses of unknown origin—specifically those not linked to environmental causes or diagnosable through existing methods. Eligibility for coverage is dependent on the necessity for a timely molecular diagnosis crucial for treatment decisions. Qualifying acute or complex illnesses are characterized by congenital anomalies impacting multiple organ systems, abnormal lab results indicating potential genetic conditions, severe metabolic disorders, muscle weaknesses, seizures, and certain cardiac or physiological irregularities. The genetic data obtained will primarily support healthcare professionals in diagnosing and treating patients, and will be safeguarded in accordance with health information privacy laws like HIPAA. The Executive Office of Health and Human Services is empowered to implement this bill, including developing necessary regulations and seeking CMS approvals to secure financial backing. The bill will take effect immediately upon passage.