I 

115TH CONGRESS 

1ST SESSION H. R. 1898 

To amend title XVIII of the Social Security Act to improve access to, 

and utilization of, bone mass measurement benefits under part B of 

the Medicare program by establishing a minimum payment amount under 

such part for bone mass measurement. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 4, 2017 

Mr. MEEHAN (for himself, Mrs. BLACKBURN, Mr. LARSON of Connecticut, Ms. 

SA ́NCHEZ, Mr. SESSIONS, Mr. ROE of Tennessee, Ms. MOORE, Mr. 

DEFAZIO, Ms. PINGREE, Ms. NORTON, Mr. GRIJALVA, and Mr. MCGOVERN) 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 improve 

access to, and utilization of, bone mass measurement 

benefits under part B of the Medicare program by establishing a minimum payment amount under such part 

for bone mass measurement. 

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

3 SECTION 1. FINDINGS. 

4 The Congress finds the following: 


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1 (1) Osteoporosis is a major public health prob2 lem with 54 million Americans as of 2010 having ei3 ther low bone mass or osteoporosis, responsible for 

4 over 2 million fractures per year, including over 

5 300,000 hip fractures. The estimated total cost of 

6 these fractures in 2005 was $17 billion and expected 

7 to rise to over $25 billion by 2025. 

8 (2) Osteoporosis is a silent disease that often is 

9 not discovered until a fracture occurs. One out of 

10 two women and up to one of four men will suffer an 

11 osteoporotic fracture in their lifetimes. 

12 (3) While both men and women may develop 

13 osteoporosis, 80 percent are women. 

14 (4) Most women are not aware of their personal 

15 risk factors for osteoporosis, the prevalence of, or 

16 the morbidity and mortality associated with the dis17 ease, despite the fact that broken bones due to 

18 osteoporosis lead to more hospitalizations and great19 er health care costs than heart attack, stroke, or 

20 breast cancer in women age 55 and above. 

21 (5) A woman’s risk of hip fracture is equal to 

22 her combined risk of breast, uterine, and ovarian 

23 cancer. More women die in the United States in the 

24 year following a hip fracture than from breast can25 cer. 


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1 (6) One out of four people who have an 

2 osteoporotic hip fracture will need long-term nursing 

3 home care. Half of those who experience osteoporotic 

4 hip fractures are unable to walk without assistance. 

5 (7) Elderly women are so afraid of losing their 

6 independence that 8 in 10 would rather die than 

7 break their hip and be admitted to a nursing home. 

8 (8) Bone density testing is more powerful in 

9 predicting fractures than cholesterol is in predicting 

10 myocardial infarction or blood pressure in predicting 

11 stroke. 

12 (9) Osteoporosis remains both under-recognized 

13 and under-treated. Over a 7-year period (2007– 

14 2013), 45 percent of older female Medicare bene15 ficiaries had no DXA bone density test, and 25 per16 cent had only one test. 

17 (10) DXA testing in older women declined in 

18 2014 to the lowest point in 10 years. 

19 (11) A decade of steady decline in hip fractures 

20 stopped abruptly in 2013. Since then, there have 

21 been more than 14,000 additional hip fractures, 

22 costing over $560 million, leading to 2,800 more 

23 deaths than expected if the decline had continued. 


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1 SEC. 2. INCREASING ACCESS TO OSTEOPOROSIS PREVEN2 TION AND TREATMENT. 

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

4 1395w–4(b)) is amended— 

5 (1) in paragraph (4)(B)— 

6 (A) by striking ‘‘and the first 2 months of 

7 2012’’ and inserting ‘‘the first 2 months of 

8 2012, 2017, and each subsequent year’’; and 

9 (B) by striking ‘‘paragraph (6)’’ and in10 serting ‘‘paragraphs (6) and (12)’’; and 

11 (2) by adding at the end the following: 

12 ‘‘(12) ESTABLISHING MINIMUM PAYMENT FOR

13 OSTEOPOROSIS TESTS.—For dual-energy x-ray 

14 absorptiometry services (identified by HCPCS codes 

15 77080 and 77082 and successor codes 77085 and 

16 77086 (and any succeeding codes)) furnished during 

17 2017 or a subsequent year, the Secretary shall es18 tablish a national minimum payment amount under 

19 this subsection— 

20 ‘‘(A) for such services identified by 

21 HCPCS code 77080, equal to $98 (with na22 tional minimum payment amounts of $87.11 for 

23 the technical component and $10.89 for the 

24 professional component); and 

25 ‘‘(B) for such services identified by 

26 HCPCS code 77086, equal to $35 (with naVerDate Sep 11 2014 00:33 Apr 11, 2017 Jkt 069200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1898.IH H1898

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1 tional minimum payment amounts of $27.18 for 

2 the technical component and $7.82 for the pro3 fessional component); and 

4 ‘‘(C) for the bundled code for dual energy 

5 absorptiometry and vertebral fracture assess6 ment studies identified as HCPCS code 77085, 

7 equal to $133 (with national minimum payment 

8 amounts of $114.29 for the technical compo9 nent and $18.71 for the professional compo10 nent). 

11 Such minimum payment amounts shall be adjusted 

12 by the geographical adjustment factor established 

13 under subsection (e)(2) for the services for the re14 spective year.’’. 

Æ 


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