SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Older Americans Preventive Health 
Act of 1993''.

SEC. 2. MEDICARE COVERAGE OF COMPREHENSIVE HEALTH ASSESSMENT.

    (a) In General.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)) is amended--
            (1) by striking ``and'' at the end of subparagraph (O);
            (2) by striking the semicolon at the end of subparagraph 
        (P) and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
            ``(Q) comprehensive health assessment (as defined in 
        subsection (oo));''.
    (b) Comprehensive Health Assessment Defined.--Section 1861 of such 
Act (42 U.S.C. 1395x) is amended by adding at the end the following new 
subsection:

                   ``comprehensive health assessment

    ``(oo)(1) The term `comprehensive health assessment' means a 
procedure conducted by a primary care physician (as defined in 
paragraph (3)) that is provided to an individual enrolled under part B 
who elects to receive coverage for such assessment (at such time and in 
such manner as the Secretary may provide by regulation) and that 
consists of the following examinations, tests, and procedures:
            ``(A) The taking of a health history.
            ``(B) A physical examination, including an examination for 
        height, weight, blood pressure, visual acuity, hearing, and 
        palpation for pre-clinical disease.
            ``(C) Laboratory and screening procedures, including--
                    ``(i) nonfasting total blood cholesterol;
                    ``(ii) fecal occult blood testing, and
                    ``(iii) sigmoidoscopy (in accordance with a 
                periodicity schedule established by the Secretary).
            ``(D) Counseling services, including counseling relating 
        to--
                    ``(i) exercise;
                    ``(ii) smoking cessation;
                    ``(iii) substance abuse prevention;
                    ``(iv) injury prevention;
                    ``(v) dental health;
                    ``(vi) prescription drug use;
                    ``(vii) the need to visit eye specialists for 
                glaucoma testing;
                    ``(viii) diet;
                    ``(ix) in the case of women, the need for regular 
                mammograms and pap smears; and
                    ``(x) in the case of individuals identified as 
                being at high risk for specific medical conditions, 
                counseling for--
                            ``(I) estrogen replacement therapy,
                            ``(II) aspirin therapy, and
                            ``(III) skin protection from ultraviolet 
                        light.
    ``(2) For purposes of this subsection, the term `primary care 
physician' includes a physician (described in section 1861(r)(1)) who 
is a family practitioner, general practitioner, internal medicine 
specialist, general preventive medicine specialist, obstetrical or 
gynecological specialist, pediatrician.''.
    (c) Amount of Payment; Waiver of Copayment.--(1) Section 1833(a)(1) 
of such Act (42 U.S.C. 1395l(a)(1)) is amended--
            (A) by striking ``1834(h)(1), (M)'' and inserting 
        ``1834(h)(1), (N)'';
            (B) by striking ``(r)(2)) and (N)'' and inserting 
        ``(r)(2)), (O)''; and
            (C) by striking the semicolon at the end and inserting the 
        following: ``, and (P) with respect to expenses incurred for a 
        comprehensive health assessment (as described in section 
        1861(oo)), the amounts paid shall be 100 percent of the 
        reasonable charge for such assessment or the fee schedule 
        amount determined under section 1848 for such assessment;''.
    (2) The second to last sentence of section 1866(a)(2)(A) of such 
Act (42 U.S.C. 1395cc(a)(2)(A)) is amended by inserting after ``with 
the first opinion),'' the following: ``with respect to a comprehensive 
health assessment (as described in section 1861(oo)),''.
    (d) Financing Through Increase in Part B Premium.--Section 1839 of 
such Act (42 U.S.C. 1395r) is amended by adding at the end the 
following new subsection:
    ``(g) Notwithstanding any other provision of this section, in the 
case of an individual enrolled under this part who elects to receive 
coverage for a comprehensive health assessment pursuant to section 
1861(oo)(1) for months in a calendar year, the amount of the monthly 
premium otherwise applicable to the individual under this section for 
months in such year shall be increased by such amount as the Secretary 
determines to be necessary to ensure that the amount of expenditures 
made under this part during the year as a result of the enactment of 
the Older Americans Preventive Health Act of 1993 will not exceed the 
amount of expenditures that would have been made under this part during 
the year if such Act had not been enacted into law.''.
    (e) Effective Date.--The amendments made by this sections shall 
apply to services furnished on or after January 1, 1994.

SEC. 2. MEDICARE COVERAGE OF CERTAIN IMMUNIZATIONS.

    (a) In General.--Section 1861(s)(10) of the Social Security Act (42 
U.S.C. 1395x(s)(10)) is amended--
            (1) in subparagraph (A), by striking ``; and'' and 
        inserting a comma;
            (2) in subparagraph (B), by striking the semicolon at the 
        end and inserting ``, and''; and
            (3) by adding at the end the following new subparagraph:
            ``(C) such immunizations as the Secretary designates for 
        prevention or treatment of tuberculosis, meningococcal 
        meningitis, tetanus, diptheria, and such other infectious 
        diseases as the Secretary determines present a public health 
        problem, furnished to individuals who, as determined in 
        accordance with regulations promulgated by the Secretary, are 
        at high risk of contracting any of such diseases;''.
    (b) Waiver of Copayment.--(1) Section 1833(a)(1)(B) of such Act (42 
U.S.C. 1395l(a)(1)(B)) is amended by striking ``1861(s)(10)(A)'' and 
inserting ``1861(s)(10)''.
    (2) The third sentence of section 1866(a)(2)(A) of such Act (42 
U.S.C. 1395cc(a)(2)(A)) is amended by striking ``1861(s)(10)(A)'' and 
inserting ``1861(s)(10)''.
    (c) Effective Date.--The amendments made by subsections (a) and (b) 
shall apply to items and services furnished on or after January 1, 
1994.

SEC. 3. ADDITIONAL AUTHORIZATION OF APPROPRIATIONS FOR PROVISION OF 
              EDUCATION AND INFORMATION REGARDING CANCER.

    Section 408(a)(1) of the Public Health Service Act (42 U.S.C. 
284c(a)(1)) is amended by adding at the end the following new 
subparagraph:
            ``(C)(i) Subject to clause (ii), for the purpose of 
        providing under sections 412 and 413 education and information 
        regarding cancer to health professionals and the public, there 
        are authorized to be appropriated such sums as may be necessary 
        for each of the fiscal years 1994 through 1996. The 
        authorization of appropriations established in the preceding 
        sentence is in addition to any other authorization of 
        appropriations that is available for such purpose.
            ``(ii) In carrying out the purpose described in clause (i) 
        with amounts appropriated under such clause, the Director of 
        the Cancer Institute shall give priority to carrying out the 
        purpose with respect to low-income individuals.''.
Older Americans Preventive Health Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of a comprehensive health assessment and certain immunizations under Medicare part B (Supplementary Medical Insurance). 
Amends the Public Health Service Act to authorize additional appropriations for the provision of education and information regarding cancer to health professionals and the public.
Older Americans Preventive Health Act of 1993