II 

112TH CONGRESS 

1ST SESSION S. 1967 

To amend title XVIII of the Social Security Act to provide for the treatment 

of certain physician pathology services under the Medicare Program. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 8, 2011 

Mr. JOHNSON of South Dakota (for himself and Mr. COCHRAN) introduced 

the following bill; which was read twice and referred to the Committee 

on Finance 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for the treatment of certain physician pathology services 

under the Medicare Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Physician Pathology 

5 Services Continuity Act of 2012’’. 

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1 SEC. 2. PERMANENT TREATMENT OF CERTAIN PHYSICIAN 

2 PATHOLOGY SERVICES UNDER MEDICARE. 

3 Section 1848(i) of the Social Security Act (42 U.S.C. 

4 1395w–4(i)) is amended by adding at the end the fol5 lowing new paragraph: 

6 ‘‘(4) TREATMENT OF CERTAIN PHYSICIAN PA7 THOLOGY SERVICES.— 

8 ‘‘(A) IN GENERAL.—With respect to serv9 ices furnished on or after January 1, 2012, if 

10 an independent laboratory furnishes the tech11 nical component of a physician pathology serv12 ice to a fee-for-service medicare beneficiary who 

13 is an inpatient or outpatient of a covered hos14 pital, the Secretary shall treat such component 

15 as a service for which payment shall be made 

16 to the laboratory under this section and not as 

17 an inpatient hospital service for which payment 

18 is made to the hospital under section 1886(d) 

19 or as a hospital outpatient service for which 

20 payment is made to the hospital under section 

21 1833(t). 

22 ‘‘(B) DEFINITIONS.—In this paragraph: 

23 ‘‘(i) COVERED HOSPITAL.— 

24 ‘‘(I) IN GENERAL.—The term 

25 ‘covered hospital’ means, with respect 

26 to an inpatient or outpatient, a hosmstockstill on DSK4VPTVN1PROD with BILLS

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1 pital that had an arrangement with 

2 an independent laboratory that was in 

3 effect as of July 22, 1999, under 

4 which a laboratory furnished the tech5 nical component of physician pathol6 ogy services to fee-for-service medi7 care beneficiaries who were hospital 

8 inpatients or outpatients, respectively, 

9 and submitted claims for payment for 

10 such component to a carrier with a 

11 contract under section 1842 and not 

12 to the hospital. 

13 ‘‘(II) CHANGE IN OWNERSHIP

14 DOES NOT AFFECT DETERMINA15 TION.—A change in ownership with 

16 respect to a hospital on or after the 

17 date referred to in subclause (I) shall 

18 not affect the determination of wheth19 er such hospital is a covered hospital 

20 for purposes of such subclause. 

21 ‘‘(ii) FEE-FOR-SERVICE MEDICARE

22 BENEFICIARY.—The term ‘fee-for-service 

23 medicare beneficiary’ means an individual 

24 who is entitled to (or enrolled for) benefits 

25 under part A, or enrolled under this part, 

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1 or both, but who is not enrolled in any of 

2 the following: 

3 ‘‘(I) A Medicare Advantage plan 

4 under part C. 

5 ‘‘(II) A plan offered by an eligi6 ble organization under section 1876. 

7 ‘‘(III) A program of all-inclusive 

8 care for the elderly (PACE) under 

9 section 1894. 

10 ‘‘(IV) A social health mainte11 nance organization (SHMO) dem12 onstration project established under 

13 section 4018(b) of the Omnibus 

14 Budget Reconciliation Act of 1987 

15 (Public Law 100–203). 

16 ‘‘(C) REFERENCE.—For the treatment of 

17 certain physician pathology services furnished 

18 prior to January 1, 2012, see section 542 of the 

19 Medicare, Medicaid, and SCHIP Benefits Im20 provement and Protection Act of 2000, as ex21 tended by— 

22 ‘‘(i) Centers for Medicare & Medicaid 

23 Services (CMS) Program Memorandum for 

24 Carriers (transmittal B–03–001), issued 

25 January 17, 2003; 

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1 ‘‘(ii) CMS Manual System, Publica2 tion 100–20 One-Time Notification (trans3 mittal 34), issued December 24, 2003; 

4 ‘‘(iii) section 732 of the Medicare Pre5 scription Drug, Improvement, and Mod6 ernization Act of 2003; 

7 ‘‘(iv) section 104 of division B of the 

8 Tax Relief and Health Care Act of 2006; 

9 ‘‘(v) section 104 of the Medicare, 

10 Medicaid, and SCHIP Extension Act of 

11 2007; 

12 ‘‘(vi) section 136 of the Medicare Im13 provements for Patients and Providers Act 

14 of 2008; and 

15 ‘‘(vii) section 105 of the Medicare and 

16 Medicaid Extenders Act of 2010.’’. 

Æ 

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