Cardiovascular Disease Early Detection and Prevention Act of 2026

(a) Public Health Service Act. Section 2713(a) of the Public Health Service Act (42 U.S.C. 300gg–13(a)) is amended—

(1) in paragraph (2), by striking and at the end;

(2) in paragraph (3), by striking the period and inserting a semicolon;

(3) by redesignating paragraphs (4) and (5) as paragraphs (5) and (6), respectively; and

(4) by inserting after paragraph (3) the following new paragraph:

(4) with respect to individuals with a family history of premature cardiovascular disease, a personal history of myocardial infarction, stroke, or elevated LDL cholesterol, a diagnosis of diabetes mellitus or obesity, or other recognized cardiovascular risk factors, testing for lipoprotein(a) and apolipoprotein B levels; and

(b) Medicare

(1) In general. Section 1861(xx)(1) of the Social Security Act (42 U.S.C. 1395x(xx)(1)) is amended—

(A) by redesignating subparagraph (B) as subparagraph (C);

(B) by inserting after subparagraph (A) the following new subparagraph:

(B) In the case of an individual with a family history of premature cardiovascular disease, a personal history of myocardial infarction, stroke, or elevated LDL cholesterol, a diagnosis of diabetes mellitus or obesity, or other recognized cardiovascular risk factors, lipoprotein(a) and apolipoprotein B levels.

; and

(C) in the flush matter at the end, by striking subparagraph (B) and inserting subparagraph (C).

(2) No application of cost sharing. Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended—

(A) in subsection (a)(1)(Y), by inserting (other than tests for levels described in section 1861(ww)(1)(B) furnished to an individual described in such section) after described in subparagraph (A); and

(B) in subsection (b)(1), by striking for the individual. inserting for the individual or that are tests for levels described in section 1861(ww)(1)(B) furnished to an individual described in such section.

(c) Medicaid

(1) In general. Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended—

(A) in paragraph (31), by striking and at the end;

(B) by redesignating paragraph (32) as paragraph (33); and

(C) by inserting after paragraph (31) the following new paragraph:

(32) testing for lipoprotein(a) and apolipoprotein B levels furnished to an individual with a family history of premature cardiovascular disease, a personal history of myocardial infarction, stroke, or elevated LDL cholesterol, a diagnosis of diabetes mellitus or obesity, or other recognized cardiovascular risk factors; and

(2) No cost sharing

(A) In general. Subsections (a)(2) and (b)(2) of section 1916 of the Social Security Act (42 U.S.C. 1396o) are each amended—

(i) in subparagraph (I), by striking or at the end;

(ii) in subparagraph (J), by striking ; and and inserting , or; and

(iii) by adding at the end the following new subparagraph:

(K) testing for lipoprotein(a) and apolipoprotein B levels furnished to an individual described in section 1905(a)(32); and

(B) Application to alternative cost sharing. Section 1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended by adding at the end the following new clause:

(xv) Testing for lipoprotein(a) and apolipoprotein B levels furnished to an individual described in section 1905(a)(32).

(3) Mandatory coverage. Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by striking and (30) and inserting (30), and (32).

(4) Benchmark coverage and benchmark-equivalent coverage. Section 1937(b) of the Social Security Act (42 U.S.C. 1396u–7(b)) is amended by adding at the end the following new paragraph:

(9) Coverage of certain lipid level testing. Notwithstanding the previous provisions of this section, a State may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark-equivalent coverage under this section unless such coverage provides, with respect to an individual described in section 1905(a)(32), testing for lipoprotein(a) and apolipoprotein B levels.

(d) Effective date. The amendments made by—

(1) subsection (a) shall apply with respect to plan years beginning on or after the date that is 180 days after the date of the enactment of this Act; and

(2) subsections (b) and (c) shall apply with respect to items and services and medical assistance, respectively, furnished on or after such date.