On March 16, 2018, the US Centers for Medicare & Medicaid Services (CMS) finalized a national coverage determination (NCD) on how it intends to reimburse next-generation sequencing (NGS) for Medicare beneficiaries.1 The NCD allows automatic coverage of US Food and Drug Administration (FDA)–approved NGS testing for patients covered by Medicare and for additional testing when the patient has a new primary cancer diagnosis. Although this ruling creates an immediate effect on all stakeholders of the health care delivery model, it falls short of advancing science, medicine, and public health.