[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4879 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 4879

 To amend title XVIII of the Social Security Act to include screening 
  computed tomography colonography as a colorectal screening test for 
    purposes of coverage under the Medicare Program, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 19, 2007

 Mrs. Cubin (for herself and Mr. Towns) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
    addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to include screening 
  computed tomography colonography as a colorectal screening test for 
    purposes of coverage under the Medicare Program, and for other 
                               purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Virtual Screening for Cancer Act of 
2007''.

SEC. 2. SCREENING COMPUTED TOMOGRAPHY COLONOGRAPHY INCLUDED AS A 
              COLORECTAL SCREENING TEST FOR PURPOSES OF COVERAGE UNDER 
              THE MEDICARE PROGRAM.

    (a) In General.--Section 1861(pp)(1) of the Social Security Act (42 
U.S.C. 1395x(pp)(1)) is amended--
            (1) by redesignating subparagraph (D) as subparagraph (E); 
        and
            (2) by inserting after subparagraph (C) the following new 
        subparagraph:
                    ``(D) Screening computed tomography 
                colonography.''.
    (b) Frequency Limits and Payment for Screening Computed Tomography 
Colonography.--Section 1834(d) of the Social Security Act (42 U.S.C. 
1395m(d)) is amended by adding at the end the following new paragraph:
            ``(4) Screening computed tomography colonography.--
                    ``(A) Fee schedule.--With respect to a colorectal 
                cancer screening test consisting of screening computed 
                tomography colonography, payment under section 1848 
                shall be consistent with payment under such section for 
                similar or related services.
                    ``(B) Payment limit.--In the case of screening 
                computed tomography colonography, payment under this 
                part shall not exceed such amount as the Secretary 
                specifies, based upon rates recognized for diagnostic 
                computed tomography colonography.
                    ``(C) Facility payment limit.--
                            ``(i) In general.--Notwithstanding 
                        subsections (i)(2)(A) and (t) of section 1833, 
                        in the case of screening computed tomography 
                        colonography furnished on or after January 1, 
                        2008, that--
                                    ``(I) in accordance with 
                                regulations, may be performed in an 
                                ambulatory surgical center and for 
                                which the Secretary permits ambulatory 
                                surgical center payments under this 
                                part; and
                                    ``(II) are performed in an 
                                ambulatory surgical center or hospital 
                                outpatient department,
                        payment under this part shall be based on the 
                        lesser of the amount under the fee schedule 
                        that would apply to such services if they were 
                        performed in a hospital outpatient department 
                        in an area or the amount under the fee schedule 
                        that would apply to such services if they were 
                        performed in an ambulatory surgical center in 
                        the same area.
                            ``(ii) Limitation on coinsurance.--
                        Notwithstanding any other provision of this 
                        title, in the case of a beneficiary who 
                        receives the services described in clause (i)--
                                    ``(I) in computing the amount of 
                                any applicable copayment, the 
                                computation of such coinsurance shall 
                                be based upon the fee schedule under 
                                which payment is made for the services; 
                                and
                                    ``(II) the amount of such 
                                coinsurance shall not exceed 25 percent 
                                of the payment amount under the fee 
                                schedule described in subclause (I).
                    ``(D) Frequency limit.--No payment may be made 
                under this part for a colorectal cancer screening test 
                consisting of a screening computed tomography 
                colonography--
                            ``(i) if the individual is under 50 years 
                        of age; or
                            ``(ii)(I) in the case of individuals at 
                        high risk for colorectal cancer, if the 
                        procedure is performed within the 23 months 
                        after a previous screening computed tomography 
                        colonography or a previous screening 
                        colonoscopy; or
                            ``(II) in the case of an individual who is 
                        not at high risk for colorectal cancer, if the 
                        procedure is performed within the 119 months 
                        after a previous screening colonoscopy or 
                        within the 47 months after a previous screening 
                        flexible sigmoidoscopy or a previous screening 
                        computed tomography colonography.''.
    (c) Conforming Frequency Limits for Other Colorectal Cancer 
Screening Tests.--
            (1) Screening flexible sigmoidoscopy.--Paragraph (2)(E)(ii) 
        of section 1834(d) of the Social Security Act (42 U.S.C. 
        1395m(d)) is amended by inserting ``or screening computed 
        tomography colonography'' after ``previous screening flexible 
        sigmoidoscopy''.
            (2) Screening colonoscopy.--Paragraph (3)(E) of such 
        section is amended--
                    (A) by inserting ``or screening computed tomography 
                colonography'' after ``23 months after a previous 
                screening colonoscopy''; and
                    (B) by inserting ``or screening computed tomography 
                colonography'' after ``screening flexible 
                sigmoidoscopy''.
    (d) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after January 1, 2009.

SEC. 3. EXEMPTION OF SCREENING COMPUTED TOMOGRAPHY COLONOGRAPHY FROM 
              SPECIAL RULE ON IMAGING SERVICES.

    (a) In General.--Section 1848(b)(4)(B) of the Social Security Act 
(42 U.S.C. 1395w-4(b)(4)(B)) is amended by inserting ``and screening 
computed tomography colonography'' after ``diagnostic and screening 
mammography''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to items and services furnished on or after January 1, 2009.
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