[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2115 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                S. 2115

To amend title XVIII of the Social Security Act to extend for 6 months 
    the eligibility period for the ``Welcome to Medicare'' physical 
examination and to provide for the coverage and waiver of cost-sharing 
          for preventive services under the Medicare program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 27, 2007

  Mr. Cardin introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to extend for 6 months 
    the eligibility period for the ``Welcome to Medicare'' physical 
examination and to provide for the coverage and waiver of cost-sharing 
          for preventive services under the Medicare program.

    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 ``Medicare Preventive Services 
Coverage Act of 2007''.

SEC. 2. EXTENDING THE ELIGIBILITY PERIOD FOR A ``WELCOME TO MEDICARE'' 
              PHYSICAL EXAMINATION FROM SIX MONTHS TO ONE YEAR.

    (a) In General.--Section 1862(a)(1)(K) of the Social Security Act 
(42 U.S.C. 1395y(a)(1)(K)) is amended by striking ``6 months'' and 
inserting ``1 year''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to initial preventive physician examinations performed on or 
after January 1, 2008.

SEC. 3. COVERAGE AND WAIVER OF COST-SHARING FOR PREVENTIVE SERVICES.

    (a) Preventive Services Defined; Coverage of Additional Preventive 
Services.--Section 1861 of the Social Security Act (42 U.S.C. 1395x) is 
amended--
            (1) in subsection (s)(2)--
                    (A) in subparagraph (Z), by striking ``and'' after 
                the semicolon at the end;
                    (B) in subparagraph (AA), by adding ``and'' after 
                the semicolon at the end; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(BB) additional preventive services (described in 
        subsection (ccc)(1)(O));''; and
            (2) by adding at the end the following new subsection:

                         ``Preventive Services

    ``(ccc)(1) The term `preventive services' means the following:
                    ``(A) Prostate cancer screening tests (as defined 
                in subsection (oo)).
                    ``(B) Colorectal cancer screening tests (as defined 
                in subsection (pp)).
                    ``(C) Diabetes outpatient self-management training 
                services (as defined in subsection (qq)).
                    ``(D) Screening for glaucoma for certain 
                individuals (as described in subsection (s)(2)(U)).
                    ``(E) Medical nutrition therapy services for 
                certain individuals (as described in subsection 
                (s)(2)(V)).
                    ``(F) An initial preventive physical examination 
                (as defined in subsection (ww)).
                    ``(G) Cardiovascular screening blood tests (as 
                defined in subsection (xx)(1)).
                    ``(H) Diabetes screening tests (as defined in 
                subsection (yy)).
                    ``(I) Ultrasound screening for abdominal aortic 
                aneurysm for certain individuals (as described in 
                subsection (s)(2)(AA)).
                    ``(J) Pneumococcal and influenza vaccine and their 
                administration (as described in subsection (s)(10)(A)).
                    ``(K) Hepatitis B vaccine and its administration 
                for certain individuals (as described in subsection 
                (s)(10)(B)).
                    ``(L) Screening mammography (as defined in 
                subsection (jj)).
                    ``(M) Screening pap smear and screening pelvic exam 
                (as described in subsection (s)(14)).
                    ``(N) Bone mass measurement (as defined in 
                subsection (rr)).
                    ``(O) Additional preventive services (as determined 
                under paragraph (2)).
            ``(2)(A) The term `additional preventive services' means 
        items and services, including mental health services, not 
        described in subparagraphs (A) through (N) of paragraph (1) 
        that the Secretary determines to be reasonable and necessary 
        for the prevention or early detection of an illness or 
        disability.
            ``(B) In making determinations under subparagraph (A), the 
        Secretary shall--
                    ``(i) take into account evidence-based 
                recommendations by the United States Preventive 
                Services Task Force and other appropriate 
                organizations; and
                    ``(ii) use the process for making national coverage 
                determinations (as defined in section 1869(f)(1)(B)) 
                under this title.''.
    (b) Payment and Elimination of Cost-Sharing.--
            (1) In general.--
                    (A) In general.--Section 1833(a)(1) of the Social 
                Security Act (42 U.S.C. 1395l(a)(1)) is amended--
                            (i) in clause (T), by striking ``80 
                        percent'' and inserting ``100 percent'';
                            (ii) by striking ``and'' before ``(V)''; 
                        and
                            (iii) by inserting before the semicolon at 
                        the end the following: ``, and (W) with respect 
                        to additional preventive services (as defined 
                        in section 1861(ccc)(2)) and other preventive 
                        services for which a payment rate is not 
                        otherwise established under this section, the 
                        amount paid shall be 100 percent of the lesser 
                        of the actual charge for the services or the 
                        amount determined under a fee schedule 
                        established by the Secretary for purposes of 
                        this clause''.
                    (B) Application to sigmoidoscopies and 
                colonoscopies.--Section 1834(d) of the Social Security 
                Act (42 U.S.C. 1395m(d)) is amended--
                            (i) in paragraph (2)(C), by amending clause 
                        (ii) to read as follows:
                            ``(ii) No coinsurance.--In the case of a 
                        beneficiary who receives services described in 
                        clause (i), there shall be no coinsurance 
                        applied.''; and
                            (ii) in paragraph (3)(C), by amending 
                        clause (ii) to read as follows:
                            ``(ii) No coinsurance.--In the case of a 
                        beneficiary who receives services described in 
                        clause (i), there shall be no coinsurance 
                        applied.''.
            (2) Elimination of coinsurance in outpatient hospital 
        settings.--
                    (A) Exclusion from opd fee schedule.--Section 
                1833(t)(1)(B)(iv) of the Social Security Act (42 U.S.C. 
                1395l(t)(1)(B)(iv)) is amended by striking ``screening 
                mammography (as defined in section 1861(jj)) and 
                diagnostic mammography'' and inserting ``diagnostic 
                mammography and preventive services (as defined in 
                section 1861(ccc)(1))''.
                    (B) Conforming amendments.--Section 1833(a)(2) of 
                the Social Security Act (42 U.S.C. 1395l(a)(2)) is 
                amended--
                            (i) in subparagraph (F), by striking 
                        ``and'' after the semicolon at the end;
                            (ii) in subparagraph (G)(ii), by adding 
                        ``and'' at the end; and
                            (iii) by adding at the end the following 
                        new subparagraph:
                    ``(H) with respect to additional preventive 
                services (as defined in section 1861(ccc)(2)) furnished 
                by an outpatient department of a hospital, the amount 
                determined under paragraph (1)(W);''.
            (3) Waiver of application of deductible for all preventive 
        services.--The first sentence of section 1833(b) of the Social 
        Security Act (42 U.S.C. 1395l(b)) is amended--
                    (A) in clause (1), by striking ``items and services 
                described in section 1861(s)(10)(A)'' and inserting 
                ``preventive services (as defined in section 
                1861(ccc)(1))'';
                    (B) by inserting ``and'' before ``(4)''; and
                    (C) by striking clauses (5) through (8).
    (c) Inclusion as Part of Initial Preventive Physical Examination.--
Section 1861(ww)(2) of the Social Security Act (42 U.S.C. 1395x(ww)(2)) 
is amended by adding at the end the following new subparagraph:
                    ``(M) Additional preventive services (as defined in 
                subsection (ccc)(2)).''.
    (d) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after January 1, 2008.
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