[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2043 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 2043

To amend title XVIII of the Social Security Act to ensure the continued 
 access of Medicare beneficiaries to diagnostic imaging services, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 28, 2015

   Mr. Olson (for himself, Ms. McCollum, Mr. Roskam, and Mr. Nunes) 
 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 ensure the continued 
 access of Medicare beneficiaries to diagnostic imaging services, 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 ``Diagnostic Imaging Services Access 
Protection Act of 2015''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Significant reimbursement cuts to the Medicare 
        physician fee schedule should be based on detailed empirical 
        analysis data.
            (2) On multiple occasions since 2011, Congress has 
        requested the Centers for Medicare & Medicaid Services (CMS) to 
        provide the data used to establish its 2012 multiple procedure 
        payment reduction to the professional component of imaging 
        services.
            (3) CMS never provided the requested data to Congress.
            (4) Enactment of section 220(i) of Public Law 113-93 on 
        April 1, 2014, mandates the disclosure of CMS data used to 
        determine its 2012 multiple procedure payment reduction to the 
        professional component of imaging services.
            (5) CMS acknowledged its responsibility to disclose this 
        data in the Calendar Year 2015 Medicare Physician Fee Schedule 
        Notice of Proposed Rule Making (NPRM) released on July 11, 
        2014, as well as in a letter from the Administrator on August 
        18, 2014.
            (6) To date, CMS has not complied with the statutory 
        mandate provided for in section 220(i) of Public Law 113-93.

SEC. 3. MEDICARE PAYMENT FOR IMAGING SERVICES.

    Section 1848(b)(4) of the Social Security Act (42 U.S.C. 1395w-
4(b)(4)) is amended by adding at the end the following new 
subparagraph:
                    ``(E) Elimination of application of multiple 
                procedure payment reduction.--
                            ``(i) In general.--The Secretary shall not 
                        apply a multiple procedure payment reduction 
                        policy to the professional component of imaging 
                        services--
                                    ``(I) furnished on a date that is 
                                more than 60 days after the date of the 
                                enactment of this subparagraph and in 
                                the year in which this subparagraph is 
                                enacted; or
                                    ``(II) furnished in any subsequent 
                                year that is prior to a year in which 
                                the Secretary conducts and publishes, 
                                as part of the Medicare Physician Fee 
                                Schedule Proposed Rule for a year, the 
                                empirical analysis described in clause 
                                (ii).
                            ``(ii) Empirical analysis described.--The 
                        empirical analysis described in this clause is 
                        an analysis of the Resource-Based Relative 
                        Value Scale (commonly known as the `RBRVS') 
                        Data Manager information that is used to 
                        determine what, if any, efficiencies exist 
                        within the professional component of imaging 
                        services when two or more studies are performed 
                        on the same patient on the same day. Such 
                        empirical analysis shall include--
                                    ``(I) work sheets and other 
                                information detailing which physician 
                                work activities performed given the 
                                typical vignettes were assigned 
                                reduction percentages of 0, 25, 50, 75 
                                and 100 percent;
                                    ``(II) a discussion of the clinical 
                                aspects that informed the assignment of 
                                the reduction percentages described in 
                                subclause (I);
                                    ``(III) an explanation of how the 
                                percentage reductions for pre-, intra- 
                                and post-service work were determined 
                                and calculated; and
                                    ``(IV) a demonstration that the 
                                Centers for Medicare & Medicaid 
                                Services has consulted with practicing 
                                radiologists to gain knowledge of how 
                                radiologists interpret studies of 
                                multiple body parts on the same 
                                individual on the same day.''.
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