US HB7118

Amends Title XIX of the Social Security Act to explicitly cover whole genome sequencing and whole exome sequencing under Medicaid for children suspected of having genetic disorders, rare diseases, or health conditions of unknown origin, including congenital anomalies, developmental delays, or intellectual disabilities

Requires testing to be available as a first-tier diagnostic test ordered by a physician, applicable in both inpatient and outpatient settings, with coverage extending to first-degree biological relatives when necessary for the child's diagnosis

Mandates that Medicaid payment for genome/exome sequencing be made separately and not bundled with other medical assistance payments

Directs HHS Secretary to convene stakeholders, conduct outreach to ensure awareness of the benefit, and publish a report within 2 years including state payment amounts and data on children receiving sequencing services

Requires GAO to collect implementation feedback and assess impacts of prior authorization, genetic counselor workforce challenges, and reimbursement alignment with Medicare fee schedules, with recommendations due within 2 years; effective date January 1, 2027