Virtual Screening for Cancer Act of 2007 - Amends title XVIII (Medicare) of the Social Security Act to: (1) provide Medicare coverage for screening computed tomography as a colorectal screening test; and (2) exclude screening computed tomography colonography from the meaning of "imaging services" for which there is a special rule regarding outpatient services department (OPD) fee schedule payments.
[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4879 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 4879
To amend title XVIII of the Social Security Act to include screening
computed tomography colonography as a colorectal screening test for
purposes of coverage under the Medicare Program, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 19, 2007
Mrs. Cubin (for herself and Mr. Towns) 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 include screening
computed tomography colonography as a colorectal screening test for
purposes of coverage under the Medicare Program, 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 ``Virtual Screening for Cancer Act of
2007''.
SEC. 2. SCREENING COMPUTED TOMOGRAPHY COLONOGRAPHY INCLUDED AS A
COLORECTAL SCREENING TEST FOR PURPOSES OF COVERAGE UNDER
THE MEDICARE PROGRAM.
(a) In General.--Section 1861(pp)(1) of the Social Security Act (42
U.S.C. 1395x(pp)(1)) is amended--
(1) by redesignating subparagraph (D) as subparagraph (E);
and
(2) by inserting after subparagraph (C) the following new
subparagraph:
``(D) Screening computed tomography
colonography.''.
(b) Frequency Limits and Payment for Screening Computed Tomography
Colonography.--Section 1834(d) of the Social Security Act (42 U.S.C.
1395m(d)) is amended by adding at the end the following new paragraph:
``(4) Screening computed tomography colonography.--
``(A) Fee schedule.--With respect to a colorectal
cancer screening test consisting of screening computed
tomography colonography, payment under section 1848
shall be consistent with payment under such section for
similar or related services.
``(B) Payment limit.--In the case of screening
computed tomography colonography, payment under this
part shall not exceed such amount as the Secretary
specifies, based upon rates recognized for diagnostic
computed tomography colonography.
``(C) Facility payment limit.--
``(i) In general.--Notwithstanding
subsections (i)(2)(A) and (t) of section 1833,
in the case of screening computed tomography
colonography furnished on or after January 1,
2008, that--
``(I) in accordance with
regulations, may be performed in an
ambulatory surgical center and for
which the Secretary permits ambulatory
surgical center payments under this
part; and
``(II) are performed in an
ambulatory surgical center or hospital
outpatient department,
payment under this part shall be based on the
lesser of the amount under the fee schedule
that would apply to such services if they were
performed in a hospital outpatient department
in an area or the amount under the fee schedule
that would apply to such services if they were
performed in an ambulatory surgical center in
the same area.
``(ii) Limitation on coinsurance.--
Notwithstanding any other provision of this
title, in the case of a beneficiary who
receives the services described in clause (i)--
``(I) in computing the amount of
any applicable copayment, the
computation of such coinsurance shall
be based upon the fee schedule under
which payment is made for the services;
and
``(II) the amount of such
coinsurance shall not exceed 25 percent
of the payment amount under the fee
schedule described in subclause (I).
``(D) Frequency limit.--No payment may be made
under this part for a colorectal cancer screening test
consisting of a screening computed tomography
colonography--
``(i) if the individual is under 50 years
of age; or
``(ii)(I) in the case of individuals at
high risk for colorectal cancer, if the
procedure is performed within the 23 months
after a previous screening computed tomography
colonography or a previous screening
colonoscopy; or
``(II) in the case of an individual who is
not at high risk for colorectal cancer, if the
procedure is performed within the 119 months
after a previous screening colonoscopy or
within the 47 months after a previous screening
flexible sigmoidoscopy or a previous screening
computed tomography colonography.''.
(c) Conforming Frequency Limits for Other Colorectal Cancer
Screening Tests.--
(1) Screening flexible sigmoidoscopy.--Paragraph (2)(E)(ii)
of section 1834(d) of the Social Security Act (42 U.S.C.
1395m(d)) is amended by inserting ``or screening computed
tomography colonography'' after ``previous screening flexible
sigmoidoscopy''.
(2) Screening colonoscopy.--Paragraph (3)(E) of such
section is amended--
(A) by inserting ``or screening computed tomography
colonography'' after ``23 months after a previous
screening colonoscopy''; and
(B) by inserting ``or screening computed tomography
colonography'' after ``screening flexible
sigmoidoscopy''.
(d) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 2009.
SEC. 3. EXEMPTION OF SCREENING COMPUTED TOMOGRAPHY COLONOGRAPHY FROM
SPECIAL RULE ON IMAGING SERVICES.
(a) In General.--Section 1848(b)(4)(B) of the Social Security Act
(42 U.S.C. 1395w-4(b)(4)(B)) is amended by inserting ``and screening
computed tomography colonography'' after ``diagnostic and screening
mammography''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to items and services furnished on or after January 1, 2009.
<all>
Introduced in House
Introduced in House
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.
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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