[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5763 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 5763

To clarify the treatment of certain DNA Specimen Provenance Assay tests 
 as reasonable and necessary for the diagnosis or treatment of illness 
                for coverage under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 13, 2016

  Mr. Bucshon (for himself, Mr. Payne, Mr. Carson of Indiana, and Mr. 
   Mullin) 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 clarify the treatment of certain DNA Specimen Provenance Assay tests 
 as reasonable and necessary for the diagnosis or treatment of illness 
                for coverage 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 ``Prostate Cancer Misdiagnosis 
Elimination Act of 2016''.

SEC. 2. CLARIFICATION OF TREATMENT OF CERTAIN DSPA TESTS AS REASONABLE 
              AND NECESSARY FOR THE DIAGNOSIS OR TREATMENT OF ILLNESS 
              FOR COVERAGE UNDER MEDICARE.

    (a) In General.--For purposes of title XVIII of the Social Security 
Act (42 U.S.C. 1395 et seq.) and regulations promulgated to carry out 
such title, a DNA Specimen Provenance Assay test (referred to in this 
section as a ``DSPA test'') furnished after the date of the enactment 
of this Act shall be deemed to be reasonable and necessary for the 
diagnosis or treatment of an illness or injury under section 
1862(a)(1)(A) of such Act (42 U.S.C. 1395y(a)(1)(A)) for purposes of 
coverage and payment under part B of such title if, subject to 
subsection (b), such test is furnished to an individual enrolled under 
part B who has had a prostate cancer biopsy the results of which are 
putatively positive and the test is furnished with respect to such 
biopsy.
    (b) Exception.--Subsection (a) shall not apply to a DSPA test 
furnished to an individual if the physician ordering such test 
recommends that treatment of prostate cancer for such individual is not 
medically necessary.
    (c) CPT Code Assignment.--Not later than 60 days after the date of 
the enactment of this Act, the Secretary of Health and Human Services 
shall assign the DSPA test to a CPT code.
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