Lung Cancer Screening Expansion Act of 2025 in plain language
1: Short title
This section would let the Act be cited as the Lung Cancer Screening Expansion Act of 2025.
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1. Short title This Act may be cited as the Lung Cancer Screening Expansion Act of 2025 .
2: Coverage requirement
This section would require all health insurers, including group health plans, health insurance issuers offering group or individual health insurance coverage, and all applicable federal health programs, to provide full coverage, with no cost-sharing to the patient, for an annual low-dose computed tomography (LDCT) screening or other appropriate lung cancer screening technology for eligible individuals as defined in section 3. It would bar insurers from requiring prior authorization for this coverage, from applying step therapy or other utilization controls, from limiting how often the screening is covered to less than once a year, and from imposing documentation requirements beyond what is included in recent evidence-based clinical guidelines.
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2. Coverage requirement (a) Coverage standard All health insurers—including a group health plan, a health insurance issuer offering group or individual health insurance coverage, and all applicable Federal health programs—shall provide full coverage, without cost-sharing, for annual low-dose computed tomography (LDCT) or other appropriate lung cancer screening technologies for eligible individuals described in section (3). (b) Prohibited barriers Coverage under this Act may not be subject to— (1) prior authorization; (2) step-therapy or other utilization controls; (3) frequency limits more restrictive than one screening annually; or (4) documentation requirements beyond those included in recent evidence-based clinical guidelines.
3: Eligible individuals
This section would define an eligible individual as an adult who is 50 to 80 years old and whom a treating health care professional determines to be at increased risk for lung cancer based on personal, environmental, or familial risk factors. Both the age range and the risk determination would have to be met for a person to qualify.
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3. Eligible individuals An eligible individual is an adult who— (1) is 50 to 80 years old; and (2) is determined by a treating health care professional to be at increased risk for lung cancer based on personal, environmental, or familial risk factors.
4: Implementation
This section would require the Secretary of Health and Human Services, the Secretary of Defense, the Secretary of Veterans Affairs, and the Director of the Office of Personnel Management to issue regulations implementing the Act within 180 days of enactment and to ensure compliance with it across their programs.
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4. Implementation The Secretary of Health and Human Services, the Secretary of Defense, the Secretary of Veterans Affairs, and the Director of the Office of Personnel Management shall issue implementing regulations within 180 days of enactment and ensure program-wide compliance.