II

106TH CONGRESS

2D SESSION S. 3024

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

of glaucoma detection services under part B of the medicare program.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 11, 2000

Mr. ROBB (for himself, Mr. CHAFEE, and Mr. MOYNIHAN) 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 coverage of glaucoma detection services under part

B of 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 ‘‘Medicare Glaucoma

5 Detection Act of 2000’’.

6 SEC. 2. MEDICARE COVERAGE OF GLAUCOMA DETECTION

7 TESTS.

8 (a) IN GENERAL.—Section 1861 of the Social Secu9 rity Act (42 U.S.C. 1395x) is amended—

10 (1) in subsection (s)(2)—
2

•S 3024 IS

1 (A) in subparagraph (S), by striking

2 ‘‘and’’ at the end;

3 (B) in subparagraph (T), by inserting

4 ‘‘and’’ at the end; and

5 (C) by adding at the end the following new

6 subparagraph:

7 ‘‘(U) glaucoma detection tests (as defined in

8 subsection (uu));’’; and

9 (2) by adding at the end the following new sub10 section:

11 ‘‘Glaucoma Detection Tests

12 ‘‘(uu) The term ‘glaucoma detection test’ means all

13 of the following conducted for the purpose of early detec14 tion of glaucoma:

15 ‘‘(1) A dilated eye examination with an intra16 ocular pressure measurement.

17 ‘‘(2) Direct ophthalmoscopy or slit-lamp bio18 microscopic examination.’’.

19 (b) LIMITATION ON ELIGIBILITY AND FREQUENCY.—

20 Section 1834 of the Social Security Act (42 U.S.C.

21 1395m) is amended by adding at the end the following

22 new subsection:

23 ‘‘(m) LIMITATION ON COVERAGE OF GLAUCOMA DE24 TECTION TESTS.—
3

•S 3024 IS

1 ‘‘(1) IN GENERAL.—Notwithstanding any other

2 provision of this part, with respect to expenses in3 curred for glaucoma detection tests (as defined in

4 section 1861(uu)), payment may be made only for

5 glaucoma detection tests conducted—

6 ‘‘(A) for individuals described in paragraph

7 (2); and

8 ‘‘(B) consistent with the frequency per9 mitted under paragraph (3).

10 ‘‘(2) INDIVIDUALS ELIGIBLE FOR BENEFIT.—

11 Individuals described in this paragraph are as fol12 lows:

13 ‘‘(A) Individuals who are 60 years of age

14 or older and who have a family history of glau15 coma.

16 ‘‘(B) Other individuals who are at high

17 risk (as determined by the Secretary) of devel18 oping glaucoma.

19 ‘‘(3) FREQUENCY LIMIT.—

20 ‘‘(A) IN GENERAL.—Subject to subpara21 graph (B), payment may not be made under

22 this part for a glaucoma detection test per23 formed for an individual within 23 months fol24 lowing the month in which a glaucoma detection
4

•S 3024 IS

1 test was performed under this part for the indi2 vidual.

3 ‘‘(B) EXCEPTION.—The Secretary may

4 permit a glaucoma detection test to be covered

5 on a more frequent basis than that provided

6 under subparagraph (A) under such cir7 cumstances as the Secretary determines to be

8 appropriate.’’.

9 (c) NO APPLICATION OF DEDUCTIBLE.—Section

10 1833(b)(5) of the Social Security Act (42 U.S.C.

11 1395l(b)(5)) is amended by inserting ‘‘or with respect to

12 glaucoma detection tests (as defined in section 1861(uu))’’

13 after ‘‘1861(jj))’’.

14 (d) CONFORMING AMENDMENTS.—Section 1862(a)

15 of the Social Security Act (42 U.S.C. 1395y(a)) is

16 amended—

17 (1) in paragraph (1)—

18 (A) in subparagraph (H), by striking

19 ‘‘and’’ at the end;

20 (B) in subparagraph (I), by striking the

21 semicolon at the end and inserting ‘‘, and’’; and

22 (C) by adding at the end the following new

23 subparagraph:

24 ‘‘(J) in the case of glaucoma detection tests (as

25 defined in section 1861(uu)), which are furnished to
5

•S 3024 IS

1 an individual not described in paragraph (2) of sec2 tion 1834(m) or which are performed more fre3 quently than is covered under paragraph (3) of such

4 section;’’; and

5 (2) in paragraph (7), by striking ‘‘or (H)’’ and

6 inserting ‘‘(H), or (I)’’.

7 (e) EFFECTIVE DATE.—The amendments made by

8 this section apply to tests provided on or after January

9 1, 2001.

Æ