[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4988 Introduced in House (IH)]

103d CONGRESS
  2d Session
                                H. R. 4988

 To provide for a four year demonstration project under Medicare which 
shall establish a preventive health care screening examination program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            August 18, 1994

Mr. Regula (for himself and Mr. Hughes) introduced the following bill; 
  which was referred jointly to the Committees on Ways and Means and 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To provide for a four year demonstration project under Medicare which 
shall establish a preventive health care screening examination program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. ESTABLISHMENT OF PREVENTIVE HEALTH CARE EXAMINATIONS.

    (a) Coverage of Preventive Health Care Examinations.--Section 
1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is 
amended by inserting ``and'' at the end of paragraph (M) and adding at 
the end thereof the following:
                    ``(N) colon cancer preventive screening examination 
                which shall be limited to either fecal occult blood 
                tests on an annual basis, or sigmoidoscopy examination 
                on an biannual basis, furnished to an individual to 
                assist in the preventive and early diagnose of colon 
                cancer; and
                    ``(O) physical examination, associated blood tests, 
                and such other tests performed by a physician, or 
                qualified health care professional, on an annual basis 
                in the preventive and early diagnose of prostate 
                cancer; and
                    ``(P) bone mass measurements (including but not 
                limited to radiographic absorptiometry, single-energy 
                photon absorptiometry or single-energy x-ray 
                absorptiometry, dual-energy x-ray absorptiometry and 
                quantitative computed tomography), and such other tests 
                as deemed appropriate by the Secretary of Health and 
                Human Services, in the preventive and early diagnose of 
                osteoporosis.''.
    (b) Contingent Effective Date; Demonstration Project.--
            (1) The amendments made by this section shall become 
        effective (if at all) in accordance with paragraph (2).
            (2) The Secretary of Health and Human Services (in this 
        paragraph referred to as the ``Secretary'') shall establish a 
        demonstration project to begin on October 1, 1994, to test the 
        cost-effectiveness of furnishing colon, prostrate, and uterine 
        cancer preventive screening examinations (in this paragraph 
        referred to as ``preventive health care examinations'') under 
        the medicare program to the extent provided under the 
        amendments made by this section to a sample group of medicare 
        beneficiaries.
                    (B)(i) The demonstration project under subparagraph 
                (A) shall be conducted for an initial period of twenty-
                four months. Not later than October 1, 1996, the 
                Secretary shall report to the Congress on the results 
                of such project. If the Secretary finds, on the basis 
                of existing data, that furnishing any of these 
                examinations under the Medicare program to the extent 
                provided under the amendments made by this section is 
                cost-effective, and useful in decreasing incidents of 
                such cancers, the Secretary shall include such finding 
                in such report, such project shall be discontinued, and 
                the amendments made by this section shall become 
                effective on November 1, 1966.
                    (ii) If the Secretary determines that such finding 
                cannot be made on the basis of existing data, such 
                project shall continue for an additional twenty-four 
                months. Not later than April 1, 1998, the Secretary 
                shall submit a final report to Congress on the results 
                of such project. The amendments made by this section 
                shall become effective on the first day of the first 
                month to begin after such report is submitted to the 
                Congress unless the report contains a finding by the 
                Secretary that furnishing preventive health care 
                examinations under the amendments made by this section 
                is not cost effective or does not reduce the incidence 
                of such cancers (in which case the amendments made by 
                this section shall not become effective).
            (3) In conducting the demonstration project in order to 
        determine the cost effectiveness and effectiveness in reducing 
        the incidence of such cancers of including preventive health 
        care examinations in the medicare program, the Secretary is 
        required to conduct a demonstration of the provision of 
        preventive health care examinations as a service for medicare 
        beneficiaries and to expend $15,000,000 each year of the 
        demonstration project for this purpose. In conducting this 
        demonstration, the Secretary is authorized to reimburse for 
        such services in large scale demonstration projects, including 
        statewide projects. In determining cost effectiveness, the 
        Secretary shall consider the direct cost of providing such 
        services, the utilization of such services which might 
        otherwise not have occurred, the costs of illnesses and nursing 
        home days avoided, and other relevant factors, except that 
        extended life for beneficiaries shall not be considered to 
        reduce the cost effectiveness of preventive health care 
        examinations.
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