PREFERRED Screening Act

S. 5258, the PREFERRED Screening Act, would direct the Secretary of Health and Human Services to create a new Medicare payment model, within two years of enactment, that reimburses eligible health providers for performing comprehensive breast cancer risk assessments and creating personalized screening and risk-reduction plans. Assessments would combine genetic testing (including BRCA1, BRCA2, and other specified genes), a polygenic risk score, family history, breast density, and lifestyle factors to sort patients into risk categories, including high-risk and elevated-risk. Resulting plans would cover screening frequency and imaging type, referrals for MRI or genetic counseling, and counseling on risk-reducing medications or lifestyle changes.

The model applies to Medicare beneficiaries (Part A or B, not Medicare Advantage) aged 40–74 without end-stage renal disease or hospice care. Eligible providers include physicians, nurse practitioners, physician assistants, certified nurse-midwives, and certified genetic counselors. Participating sites would be required to include a mix of academic centers, community practices, and rural/underserved facilities, with priority given to high-mortality states and shortage areas. Services could be delivered in person or remotely, including mailed testing kits.

The bill was introduced August 5, 2026, by Senator Bill Cassidy with Senator Murkowski as a cosponsor, and referred to the Senate Finance Committee. It would need committee action, floor votes in both chambers, and the President's signature to become law. The model itself would run for up to seven years, with interim and final reports to Congress on its effects.

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