II 111th CONGRESS 2d Session S. 3527 IN THE SENATE OF THE UNITED STATES June 24, 2010 Mr. Brown of Ohio 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 ensure access to chest radiography (x-ray) services that use Computer-Aided Detection for the purpose of early detection of lung cancer.

1.

Short title

This Act may be cited as the Medicare Lung Cancer Early Detection Promotion Act of 2010.

2.

Findings

Congress makes the following findings: (1)Lung cancer accounts for more deaths than any other cancer in both men and women. (2)According to the American Cancer Society— (A)an estimated 222,520 new cases of lung cancer are expected in 2010, accounting for about 15 percent of cancer diagnoses in 2010; and (B)an estimated 157,300 deaths from lung cancer are expected to occur in 2010, accounting for about 28 percent of all cancer deaths in 2010. (3)In the United States today, one in four cancer deaths in women is due to lung cancer. (4)African-Americans have a higher occurrence of lung cancer than any other racial or ethnic group in the United States, and Black men are 37 percent more likely to get lung cancer than White men. (5)Two-thirds of all lung cancer cases are among people 65 years and older. (6)Computer-Aided Detection (CAD) technology, when used on a common chest x-ray, can help detect lung cancer in its earliest and most treatable stages. (7)Clinical trials have shown that radiologists are able to detect more early-stage lung cancer with chest x-ray CAD technology than with chest x-rays alone. (8)In 2007, the Centers for Medicare & Medicaid Services Advisory Panel on Ambulatory Payment Classification Groups recommended payment for chest x-ray CAD technology as a special packaged code, meaning that it would be paid separately when performed by itself. The Centers for Medicare & Medicaid Services did not heed this recommendation and continues to bundle the CAD technology with the chest x-ray.

3.

Ensuring access under the Medicare program to x-ray based chest radiography that uses Computer-Aided Detection technology

Section 1834 of the Social Security Act (42 U.S.C. 1395m), as amended by sections 4105 and 10501(h)(3) of the Patient Protection and Affordable Care Act, is amended— (1)in subsection (b)(1)(B), by striking subsection (c)(1)(A) and inserting subsections (c)(1)(A) and (p); and (2)by adding at the end the following new subsection: (p)

Payment for X-Ray based chest radiography services that use Computer-Aided Detection technology for the early detection of lung cancer

(1)

In general

Notwithstanding any other provision of this part, with respect to chest radiography services (identified as of September 1, 2006, by Level 1 HCPCS codes 71010, 71020, 71021, 71022, and 71030, and as subsequently modified by the Secretary) furnished on or after January 1, 2011, that use Computer-Aided Detection Technology for the early detection of lung cancer (as defined in paragraph (2)), the amount of payment shall be equal to an amount established by the Secretary for the technical component and the professional component of the chest radiography services that use such technology. The Secretary shall establish such payment amount in a manner that will ensure appropriate access under this title to such services that use such technology. (2)

Computer-Aided Detection technology for the early detection of lung cancer defined

In this subsection, the term Computer-Aided Detection Technology for the early detection of lung cancer means a computer software technology which allows for the production of a digital chest x-ray image or the conversion of a chest x-ray into a digital image to be subsequently analyzed for early lung cancer nodules and which the Food and Drug Administration has granted approval or clearance. (3)

New codes

The Secretary shall establish new codes for chest radiography services described in paragraph (1) in order to implement this subsection. .