Assure Access to Mammography Act of 2003

Assure Access to Mammography Act of 2003 - Provides that, with respect to payment for a screening or diagnostic mammography furnished to a Medicare beneficiary, the amount of payment made to a hospital-based facility in which such screening or diagnostic mammography is performed during the applicable period is equal to 200 percent of the amount of payment that would otherwise apply under the Medicare fee schedule established under title XVIII of the Social Security Act with respect to the technical component of such screening or diagnostic mammography. Provides for not counting certain radiological residents against graduate medical education limitations.

Directs the Secretary of Health and Human Services to enter into an arrangement with the Institute of Medicine of the National Academy of Sciences to study and report to the Secretary on Medicare reimbursement for gender-specific services.

Directs the Medicare Payment Advisory Commission to study and report to Congress on Medicare reimbursement for screening services.

[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 817 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 817

To amend title XVIII of the Social Security Act to provide for enhanced 
 reimbursement under the Medicare Program for screening and diagnostic 
             mammography services, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 13, 2003

   Mr. King of New York (for himself, Mr. Hobson, Ms. Slaughter, Mr. 
  Fossella, Ms. Ros-Lehtinen, Mr. Costello, Mr. Towns, Mr. Honda, Mr. 
 Souder, Mr. Walsh, Mr. Tiberi, Mr. Boehlert, Mr. LaTourette, Mr. Neal 
of Massachusetts, Mr. Gordon, Mr. Oberstar, Mr. Reyes, Ms. Woolsey, Mr. 
   Hinchey, Mr. Strickland, Mr. McHugh, Mr. Frost, Mr. Sweeney, Ms. 
  Corrine Brown of Florida, Ms. Norton, Mr. Forbes, Ms. Bordallo, Mr. 
McIntyre, Mr. Rodriguez, Mrs. Capps, Mr. Ford, Mr. McNulty, Mr. Kildee, 
  Mr. Meehan, Mr. Deutsch, Ms. Millender-McDonald, Mr. Bishop of New 
   York, Mrs. McCarthy of New York, Mrs. Christensen, Mr. Terry, Mr. 
Pascrell, Mr. Simmons, Mr. Abercrombie, Mr. Taylor of Mississippi, Mr. 
Gutierrez, Mr. LoBiondo, Mr. Payne, Mr. Rangel, Mr. Davis of Illinois, 
Mr. Delahunt, Mr. Serrano, Mrs. Jo Ann Davis of Virginia, Mr. Ackerman, 
Mrs. Kelly, Ms. Linda T. Sanchez of California, Mr. Nadler, Mr. Owens, 
  Mr. Etheridge, Mr. Farr, and Mr. Gonzalez) 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 provide for enhanced 
 reimbursement under the Medicare Program for screening and diagnostic 
             mammography 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 ``Assure Access to Mammography Act of 
2003''.

SEC. 2. ENHANCED REIMBURSEMENT UNDER THE MEDICARE PROGRAM FOR SCREENING 
              AND DIAGNOSTIC MAMMOGRAPHY SERVICES FURNISHED IN 2003.

    (a) Payments to Facilities for Screening and Diagnostic 
Mammography.--
            (1) In general.--Notwithstanding any other provision of 
        law, with respect to payment for a screening or diagnostic 
        mammography furnished to a medicare beneficiary, the amount of 
        payment made to a hospital-based facility (defined in paragraph 
        (4)) in which such screening or diagnostic mammography is 
        performed during the applicable period described in paragraph 
        (3) is equal to 200 percent of the amount of payment that would 
        otherwise apply under the fee schedule established under 
        section 1848 of the Social Security Act (42 U.S.C. 1395w-4) 
        with respect to the technical component of such screening or 
        diagnostic mammography.
            (2) Temporary payment rule.--With respect to payments to a 
        hospital-based facility for screening or diagnostic mammography 
        described in paragraph (1) during the applicable period, 
        payment shall be made to the facility for such mammography 
        pursuant to this subsection and shall not be made under section 
        1833(t) of such Act (42 U.S.C. 1395l(t)).
            (3) Applicable period.--The applicable period referred to 
        in paragraph (1) is the period beginning on the date of the 
        enactment of this Act and ending on the date the Secretary 
        establishes and implements an appropriate facility payment rate 
        under the prospective payment system for covered outpatient 
        services under such section 1833(t) for a screening or 
        diagnostic mammography furnished to a medicare beneficiary, but 
        in no case less than the amount payment provided for in 
        paragraph (1).
            (4) Hospital-based facility defined.--In this subsection, 
        the term ``hospital-based facility'' means a facility for which 
        payment is made for a diagnostic or screening mammography under 
        such section 1833(t) but for this subsection.
    (b) Not Counting Certain Radiology Residents Against Graduate 
Medical Education Limitations.--
            (1) In general.--For cost reporting periods beginning on or 
        after October 1, 2003, and before October 1, 2008, in applying 
        the limitations regarding the total number of full-time 
        equivalent residents in the field of allopathic or osteopathic 
        medicine under subsections (d)(5)(B)(v) and (h)(4)(F) of 
        section 1886 of the Social Security Act (42 U.S.C. 1395ww) for 
        a hospital, the Secretary of Health and Human Services shall 
        not take into account 1 additional resident in the field of 
        radiology per post-graduate year during each such cost 
        reporting period to the extent the hospital increases the 
        number of radiology residents above the number of such 
        residents for the hospital's most recent cost reporting period 
        ending before October 1, 2003.
            (2) Treatment for entire period of training program.--The 
        provisions of paragraph (1) shall apply for each year of the 
        full-time equivalent resident's approved medical residency 
        training program in the field of radiology not taken into 
        account by reason of paragraph (1).
    (c) Construction.--Nothing in this section shall be construed as 
affecting the provisions of section 104(d) of the Medicare, Medicaid, 
and SCHIP Benefits Improvement and Protection Act of 2000 (as enacted 
into law by section 1(a)(6) of Public Law 106-554) (relating to payment 
for new technologies).

SEC. 3. IOM STUDY AND REPORT ON MEDICARE REIMBURSEMENT FOR GENDER-
              SPECIFIC SERVICES.

    (a) Study.--The Secretary of Health and Human Services shall enter 
into an arrangement with the Institute of Medicine of the National 
Academy of Sciences to conduct a study of--
            (1) the relative value units established by the Secretary 
        under the medicare physician fee schedule under section 1848 of 
        the Social Security Act (42 U.S.C. 1395w-4) for physicians' 
        services that are gender-specific; and
            (2) adjustments to payment amounts under the prospective 
        payment systems for inpatient hospital services (under section 
        1886(d) of such Act (42 U.S.C. 1395ww(d))) and for covered 
        skilled nursing facility services (under section 1888(e) of 
        such Act (42 U.S.C. 1395yy(e))) that are gender specific.
    (b) Report.--
            (1) In general.--Such arrangement shall provide that the 
        Institute shall submit to the Secretary a report on the study 
        conducted under subsection (a) by not later than December 31, 
        2004.
            (2) Recommendations.--The report shall include such 
        recommendations regarding the appropriateness of adjusting the 
        relative value units for physicians' services or the 
        prospective payment amounts for inpatient hospital services or 
        covered skilled nursing facility services that are gender-
        specific, as the Institute determines appropriate.
            (3) Transmission to congress.--The Secretary shall promptly 
        transmit a copy of such report to Congress.

SEC. 4. MEDPAC STUDY AND REPORT ON MEDICARE REIMBURSEMENT FOR SCREENING 
              SERVICES.

    (a) Study.--The Medicare Payment Advisory Commission shall conduct 
a study of the relative value units established by the Secretary of 
Health and Human Services under the medicare physician fee schedule 
under section 1848 of the Social Security Act (42 U.S.C. 1395w-4) for 
screening services that are reimbursed under such fee schedule.
    (b) Report.--Not later than March 1, 2004, the Commission shall 
submit to Congress a report on the study conducted under subsection 
(a), together with such recommendations regarding the appropriateness 
of adjusting the relative value units for screening services that are 
reimbursed under the physician fee schedule as the Commission 
determines appropriate.
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