I 

116TH CONGRESS 

2D SESSION H. R. 8615 

To amend titles XVIII and XIX of the Social Security Act to provide for 

coverage of peripheral artery disease screening tests furnished to atrisk beneficiaries under the Medicare and Medicaid programs without 

the imposition of cost-sharing requirements, to amend title XXVII of 

the Public Health Service Act to require group health plans and health 

insurance issuers offering group or individual health insurance coverage 

to provide coverage for such screening tests furnished to at-risk enrollees 

of group health plans and group or individual health insurance coverage 

without the imposition of cost-sharing requirements, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 16, 2020 

Mr. PAYNE (for himself, Mr. RUSH, Mr. GALLEGO, Mr. THOMPSON of Mississippi, Ms. JOHNSON of Texas, and Ms. BLUNT ROCHESTER) 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 titles XVIII and XIX of the Social Security Act 

to provide for coverage of peripheral artery disease 

screening tests furnished to at-risk beneficiaries under 

the Medicare and Medicaid programs without the imposition of cost-sharing requirements, to amend title XXVII 

of the Public Health Service Act to require group health 

plans and health insurance issuers offering group or 


kjohnson on DSK79L0C42PROD with BILLS
2 

•HR 8615 IH

individual health insurance coverage to provide coverage 

for such screening tests furnished to at-risk enrollees 

of group health plans and group or individual health 

insurance coverage without the imposition of cost-sharing 

requirements, and for other purposes. 

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; FINDINGS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Amputation Reduction and Compassion Act of 2020’’ or 

6 the ‘‘ARC Act of 2020’’. 

7 (b) FINDINGS.—Congress makes the following find8 ings: 

9 (1) Atherosclerosis occurs when blood flow is 

10 reduced because arteries become narrowed or 

11 blocked with fatty deposits. 

12 (2) Atherosclerosis is responsible for more 

13 deaths in the United States than any other condi14 tion, and heart attacks, resulting from clogged coro15 nary arteries, are the leading cause of death in 

16 America. 

17 (3) Atherosclerosis also occurs in the legs and 

18 is known as peripheral artery disease (in this sub19 section referred to as ‘‘PAD’’) and having PAD sig20 nificantly increases the risk for heart attack, stroke, 

21 amputation, and death. 


kjohnson on DSK79L0C42PROD with BILLS
3 

•HR 8615 IH

1 (4) While most Americans are aware of athero2 sclerosis in the heart, many Americans have never 

3 heard of PAD and Americans with PAD are often 

4 unaware of the serious risks of the disease. 

5 (5) An estimated 21 million Americans have 

6 PAD, and about 200,000 of them—disproportion7 ately minorities—suffer avoidable amputations every 

8 year as a result of such disease. 

9 (6) According to the Dartmouth Atlas, amputa10 tion risks for African Americans living with diabetes 

11 are as much as four times higher than the national 

12 average. 

13 (7) Data analyses have similarly found that Na14 tive Americans are more than twice as likely to be 

15 subjected to amputation and Hispanics are up to 75 

16 percent more likely to have an amputation. 

17 (8) Fifty-two percent of patients with an above18 the-knee amputation and 33 percent of patients with 

19 a below-the-knee amputation will die within two 

20 years of their amputation. 

21 (9) Screening and arterial testing for PAD is 

22 cost-effective and should be part of routine medical 

23 care. 


kjohnson on DSK79L0C42PROD with BILLS
4 

•HR 8615 IH

1 (10) Once PAD is detected, amputations and 

2 deaths can be reduced through the use of national, 

3 evidence-based PAD care guidelines. 

4 SEC. 2. PERIPHERAL ARTERY DISEASE EDUCATION PRO5 GRAM. 

6 Part P of title III of the Public Health Service Act 

7 (42 U.S.C. 280g et seq.) is amended by adding at the end 

8 the following new section: 

9 ‘‘SEC. 399V–7. PERIPHERAL ARTERY DISEASE EDUCATION 

10 PROGRAM. 

11 ‘‘(a) ESTABLISHMENT.—The Secretary, acting 

12 through the Director of the Centers for Disease Control 

13 and Prevention, in collaboration with the Administrator 

14 of the Centers for Medicare & Medicaid Services and the 

15 Administrator of the Health Resources and Services Ad16 ministration, shall establish and coordinate a peripheral 

17 artery disease education program to support, develop, and 

18 implement educational initiatives and outreach strategies 

19 that inform health care professionals and the public about 

20 the existence of peripheral artery disease and methods to 

21 reduce amputations related to such disease, particularly 

22 with respect to at-risk populations. 

23 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

24 is authorized to be appropriated to carry out this section 


kjohnson on DSK79L0C42PROD with BILLS
5 

•HR 8615 IH

1 such sums as may be necessary for each of fiscal years 

2 2022 through 2026.’’. 

3 SEC. 3. MEDICARE COVERAGE OF PERIPHERAL ARTERY 

4 DISEASE SCREENING TESTS FURNISHED TO 

5 AT-RISK BENEFICIARIES WITHOUT IMPOSI6 TION OF COST SHARING REQUIREMENTS. 

7 (a) IN GENERAL.—Section 1861 of the Social Secu8 rity Act (42 U.S.C. 1395x) is amended— 

9 (1) in subsection (s)(2)— 

10 (A) in subparagraph (GG), by striking 

11 ‘‘and’’ at the end; 

12 (B) in subparagraph (HH), by striking the 

13 period at the end and inserting ‘‘; and’’; and 

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

15 subparagraph: 

16 ‘‘(II) peripheral artery disease screening 

17 tests furnished to at-risk beneficiaries (as such 

18 terms are defined in subsection (kkk)).’’; and 

19 (2) by adding at the end the following new sub20 section: 

21 ‘‘(kkk) PERIPHERAL ARTERY DISEASE SCREENING

22 TEST; AT-RISK BENEFICIARY.—(1) The term ‘peripheral 

23 artery disease screening test’ means— 


kjohnson on DSK79L0C42PROD with BILLS
6 

•HR 8615 IH

1 ‘‘(A) noninvasive physiologic studies of extrem2 ity arteries (commonly referred to as ankle-brachial 

3 index testing); 

4 ‘‘(B) arterial duplex scans of lower extremity 

5 arteries vascular; and 

6 ‘‘(C) such other items and services as the Sec7 retary determines, in consultation with relevant 

8 stakeholders, to be appropriate for screening for pe9 ripheral artery disease for at-risk beneficiaries. 

10 ‘‘(2) The term ‘at-risk beneficiary’ means an indi11 vidual entitled to, or enrolled for, benefits under part A 

12 and enrolled for benefits under part B— 

13 ‘‘(A) who is 65 years of age or older; 

14 ‘‘(B) who is at least 50 years of age but not 

15 older than 64 years of age with risk factors for ath16 erosclerosis (such as diabetes mellitus, a history of 

17 smoking, hyperlipidemia, and hypertension) or a 

18 family history of peripheral artery disease; 

19 ‘‘(C) who is younger than 50 years of age with 

20 diabetes mellitus and one additional risk factor for 

21 atherosclerosis; or 

22 ‘‘(D) with a known atherosclerotic disease in 

23 another vascular bed such as coronary, carotid, sub24 clavian, renal, or mesenteric artery stenosis, or ab25 dominal aortic aneurysm. 


kjohnson on DSK79L0C42PROD with BILLS
7 

•HR 8615 IH

1 ‘‘(3) The Secretary shall, in consultation with appro2 priate organizations, establish standards regarding the 

3 frequency for peripheral artery disease screening tests de4 scribed in subsection (s)(2)(II) for purposes of coverage 

5 under this title.’’. 

6 (b) INCLUSION OF PERIPHERAL ARTERY DISEASE

7 SCREENING TESTS IN INITIAL PREVENTIVE PHYSICAL

8 EXAMINATION.—Section 1861(ww)(2) of the Social Secu9 rity Act (42 U.S.C. 1395x(ww)(2)) is amended— 

10 (1) in subparagraph (N), by moving the mar11 gins of such subparagraph 2 ems to the left; 

12 (2) by redesignating subparagraph (O) as sub13 paragraph (P); and 

14 (3) by inserting after subparagraph (N) the fol15 lowing new subparagraph: 

16 ‘‘(O) Peripheral artery disease screening 

17 tests furnished to at-risk beneficiaries (as such 

18 terms are defined in subsection (kkk)).’’. 

19 (c) PAYMENT.— 

20 (1) IN GENERAL.—Section 1833(a) of the So21 cial Security Act (42 U.S.C. 1395l(a)) is amended— 

22 (A) in paragraph (1)— 

23 (i) in subparagraph (N), by inserting 

24 ‘‘and other than peripheral artery disease 

25 screening tests furnished to at-risk beneVerDate Sep 11 2014 00:13 Nov 13, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H8615.IH H8615

kjohnson on DSK79L0C42PROD with BILLS
8 

•HR 8615 IH

1 ficiaries (as such terms are defined in sec2 tion 1861(kkk))’’ after ‘‘other than person3 alized prevention plan services (as defined 

4 in section 1861(hhh)(1))’’; 

5 (ii) by striking ‘‘and’’ before ‘‘(DD)’’; 

6 and 

7 (iii) by striking ‘‘such service,;’’ at the 

8 end and inserting the following: ‘‘, and 

9 (EE) with respect to peripheral artery dis10 ease screening tests furnished to at-risk 

11 beneficiaries (as such terms are defined in 

12 section 1861(kkk)), the amount paid shall 

13 be 100 percent of the lesser of the actual 

14 charge for the services or the amount de15 termined under the payment basis deter16 mined under section 1848’’; and 

17 (B) in paragraph (2)— 

18 (i) in subparagraph (G), by striking 

19 ‘‘and’’ at the end; 

20 (ii) in subparagraph (H), by striking 

21 the comma at the end and inserting ‘‘; 

22 and’’; and 

23 (iii) by inserting after subparagraph 

24 (H) the following new subparagraph: 


kjohnson on DSK79L0C42PROD with BILLS
9 

•HR 8615 IH

1 ‘‘(I) with respect to peripheral artery disease 

2 screening tests (as defined in paragraph (1) of sec3 tion 1861(kkk)) furnished by an outpatient depart4 ment of a hospital to at-risk beneficiaries (as defined 

5 in paragraph (2) of such section), the amount deter6 mined under paragraph (1)(EE),’’. 

7 (2) NO DEDUCTIBLE.—Section 1833(b) of the 

8 Social Security Act (42 U.S.C. 1395l(b)) is amend9 ed, in the first sentence— 

10 (A) by striking ‘‘and’’ before ‘‘(12)’’; and 

11 (B) by inserting ‘‘, and (13) such deduct12 ible shall not apply with respect to peripheral 

13 artery disease screening tests furnished to at14 risk beneficiaries (as such terms are defined in 

15 section 1861(kkk))’’ before the period at the 

16 end. 

17 (3) EXCLUSION FROM PROSPECTIVE PAYMENT

18 SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT

19 SERVICES.—Section 1833(t)(1)(B)(iv) of the Social 

20 Security Act (42 U.S.C. 1395l(t)(1)(B)(iv)) is 

21 amended— 

22 (A) by striking ‘‘, or personalized’’ and in23 serting ‘‘, personalized’’; and 

24 (B) by inserting ‘‘, or peripheral artery 

25 disease screening tests furnished to at-risk 


kjohnson on DSK79L0C42PROD with BILLS
10 

•HR 8615 IH

1 beneficiaries (as such terms are defined in sec2 tion 1861(kkk))’’ after ‘‘personalized prevention 

3 plan services (as defined in section 

4 1861(hhh)(1))’’. 

5 (4) CONFORMING AMENDMENT.—Section 

6 1848(j)(3) of the Social Security Act (42 U.S.C. 

7 1395w–4(j)(3)) is amended by striking ‘‘(2)(FF) 

8 (including administration of the health risk assess9 ment) ,’’ and inserting ‘‘(2)(FF) (including adminis10 tration of the health risk assessment), (2)(II)’’. 

11 (d) EXCLUSION FROM COVERAGE AND MEDICARE AS

12 SECONDARY PAYER FOR TESTS PERFORMED MORE FRE13 QUENTLY THAN ALLOWED.—Section 1862(a)(1) of the 

14 Social Security Act (42 U.S.C. 1395y(a)(1)) is amended— 

15 (1) in subparagraph (O), by striking ‘‘and’’ at 

16 the end; 

17 (2) in subparagraph (P), by striking the semi18 colon at the end and inserting ‘‘, and’’; and 

19 (3) by adding at the end the following new sub20 paragraph: 

21 ‘‘(Q) in the case of peripheral artery dis22 ease screening tests furnished to at-risk bene23 ficiaries (as such terms are defined in section 

24 1861(kkk)), which are performed more fre25 quently than is covered under such section;’’. 


kjohnson on DSK79L0C42PROD with BILLS
11 

•HR 8615 IH

1 (e) AUTHORITY TO MODIFY OR ELIMINATE COV2 ERAGE OF CERTAIN PREVENTIVE SERVICES.—Section 

3 1834(n) of the Social Security Act (42 U.S.C. 1395m(n)) 

4 is amended— 

5 (1) by redesignating subparagraphs (A) and 

6 (B) of paragraph (1) as clauses (i) and (ii), respec7 tively, and moving the margins of such clauses, as 

8 so redesignated, 2 ems to the right; 

9 (2) by redesignating paragraphs (1) and (2) as 

10 subparagraphs (A) and (B), respectively, and mov11 ing the margins of such subparagraphs, as so redes12 ignated, 2 ems to the right; 

13 (3) by striking ‘‘CERTAIN PREVENTIVE SERV14 ICES’’ and all that follows through ‘‘any other provi15 sion of this title’’ and inserting: ‘‘CERTAIN PREVEN16 TIVE SERVICES.— 

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

18 provision of this title’’; and 

19 (4) by adding at the end the following new 

20 paragraph: 

21 ‘‘(2) INAPPLICABILITY.—The Secretarial au22 thority described in paragraph (1) shall not apply 

23 with respect to preventive services described in sec24 tion 1861(ww)(2)(O).’’. 


kjohnson on DSK79L0C42PROD with BILLS
12 

•HR 8615 IH

1 (f) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply with respect to items and services 

3 furnished on or after January 1, 2022. 

4 SEC. 4. MEDICAID COVERAGE OF PERIPHERAL ARTERY 

5 DISEASE SCREENING TESTS FURNISHED TO 

6 AT-RISK BENEFICIARIES WITHOUT IMPOSI7 TION OF COST SHARING REQUIREMENTS. 

8 (a) IN GENERAL.—Section 1905 of the Social Secu9 rity Act (42 U.S.C. 1396d) is amended— 

10 (1) in subsection (a)— 

11 (A) in paragraph (29), by striking ‘‘and’’ 

12 at the end; 

13 (B) by redesignating paragraph (30) as 

14 paragraph (31); and 

15 (C) by inserting after paragraph (29) the 

16 following new paragraph: 

17 ‘‘(30) peripheral artery disease screening tests 

18 furnished to at-risk beneficiaries (as such terms are 

19 defined in subsection (gg)); and’’; and 

20 (2) by adding at the end the following new sub21 section: 

22 ‘‘(gg) PERIPHERAL ARTERY DISEASE SCREENING

23 TEST; AT-RISK BENEFICIARY.— 


kjohnson on DSK79L0C42PROD with BILLS
13 

•HR 8615 IH

1 ‘‘(1) PERIPHERAL ARTERY DISEASE SCREENING

2 TEST.—The term ‘peripheral artery disease screen3 ing test’ means— 

4 ‘‘(A) noninvasive physiologic studies of ex5 tremity arteries (commonly referred to as ankle6 brachial index testing); 

7 ‘‘(B) arterial duplex scans of lower extrem8 ity arteries vascular; and 

9 ‘‘(C) such other items and services as the 

10 Secretary determines, in consultation with rel11 evant stakeholders, to be appropriate for 

12 screening for peripheral artery disease for at13 risk beneficiaries. 

14 ‘‘(2) AT-RISK BENEFICIARY.—The term ‘at-risk 

15 beneficiary’ means an individual enrolled under a 

16 State plan (or a waiver of such plan)— 

17 ‘‘(A) who is 65 years of age or older; 

18 ‘‘(B) who is at least 50 years of age but 

19 not older than 64 years of age with risk factors 

20 for atherosclerosis (such as diabetes mellitus, a 

21 history of smoking, hyperlipidemia, and hyper22 tension) or a family history of peripheral artery 

23 disease; 


kjohnson on DSK79L0C42PROD with BILLS
14 

•HR 8615 IH

1 ‘‘(C) who is younger than 50 years of age 

2 with diabetes mellitus and one additional risk 

3 factor for atherosclerosis; or 

4 ‘‘(D) with a known atherosclerotic disease 

5 in another vascular bed such as coronary, ca6 rotid, subclavian, renal, or mesenteric artery 

7 stenosis, or abdominal aortic aneurysm. 

8 ‘‘(3) FREQUENCY.—The Secretary shall, in con9 sultation with appropriate organizations, establish 

10 standards regarding the frequency for peripheral ar11 tery disease screening tests described in subsection 

12 (a)(30) for purposes of coverage under a State plan 

13 under this title.’’. 

14 (b) NO COST SHARING.— 

15 (1) IN GENERAL.—Subsections (a)(2) and 

16 (b)(2) of section 1916 of the Social Security Act (42 

17 U.S.C. 1396o) are each amended— 

18 (A) in subparagraph (F), by striking ‘‘or’’ 

19 at the end; 

20 (B) in subparagraph (G), by striking ‘‘; 

21 and’’ and inserting ‘‘, or’’; and 

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

23 subparagraph: 


kjohnson on DSK79L0C42PROD with BILLS
15 

•HR 8615 IH

1 ‘‘(H) peripheral artery disease screening 

2 tests furnished to at-risk beneficiaries (as such 

3 terms are defined in section 1905(gg)); and’’. 

4 (2) APPLICATION TO ALTERNATIVE COST SHAR5 ING.—Section 1916A(b)(3)(B) of the Social Security 

6 Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended by 

7 adding at the end the following new clause: 

8 ‘‘(xii) Peripheral artery disease 

9 screening tests furnished to at-risk bene10 ficiaries (as such terms are defined in sec11 tion 1905(gg)).’’. 

12 (c) MANDATORY COVERAGE.—Section 

13 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 

14 1396a(a)(10)(A)) is amended by striking ‘‘and (29)’’ and 

15 inserting ‘‘(29), and (30)’’. 

16 (d) CONFORMING AMENDMENTS.— 

17 (1) Section 1902(nn)(3) of the Social Security 

18 Act (42 U.S.C. 1396a(nn)(3)) is amended by strik19 ing ‘‘following paragraph (30)’’ and inserting ‘‘fol20 lowing paragraph (31)’’. 

21 (2) Section 1905(a) of the Social Security Act 

22 (42 U.S.C. 1396d(a)) is amended by striking ‘‘fol23 lowing paragraph (30)’’ and inserting ‘‘following 

24 paragraph (31)’’. 


kjohnson on DSK79L0C42PROD with BILLS
16 

•HR 8615 IH

1 SEC. 5. REQUIREMENT FOR GROUP HEALTH PLANS AND 

2 HEALTH INSURANCE ISSUERS OFFERING 

3 GROUP OR INDIVIDUAL HEALTH INSURANCE 

4 COVERAGE TO PROVIDE COVERAGE FOR PE5 RIPHERAL ARTERY DISEASE SCREENING 

6 TESTS FURNISHED TO AT-RISK ENROLLEES 

7 WITHOUT IMPOSITION OF COST SHARING RE8 QUIREMENTS. 

9 (a) IN GENERAL.—Subsection (a) of section 2713 of 

10 the Public Health Service Act (42 U.S.C. 300gg–13) is 

11 amended to read as follows: 

12 ‘‘(a) COVERAGE OF PREVENTIVE HEALTH SERV13 ICES.— 

14 ‘‘(1) IN GENERAL.—A group health plan and a 

15 health insurance issuer offering group or individual 

16 health insurance coverage shall, at a minimum, pro17 vide coverage for and shall not impose any cost shar18 ing requirements for— 

19 ‘‘(A) evidence-based items or services that 

20 have in effect a rating of ‘A’ or ‘B’ in the cur21 rent recommendations of the United States Pre22 ventive Services Task Force; 

23 ‘‘(B) immunizations that have in effect a 

24 recommendation from the Advisory Committee 

25 on Immunization Practices of the Centers for 


kjohnson on DSK79L0C42PROD with BILLS
17 

•HR 8615 IH

1 Disease Control and Prevention with respect to 

2 the individual involved; 

3 ‘‘(C) with respect to infants, children, and 

4 adolescents, evidence-informed preventive care 

5 and screenings provided for in the comprehen6 sive guidelines supported by the Health Re7 sources and Services Administration; 

8 ‘‘(D) with respect to women, such addi9 tional preventive care and screenings not de10 scribed in subparagraph (A) as provided for in 

11 comprehensive guidelines supported by the 

12 Health Resources and Services Administration 

13 for purposes of this subparagraph; and 

14 ‘‘(E) with respect to at-risk enrollees, pe15 ripheral artery disease screening tests. 

16 ‘‘(2) PERIPHERAL ARTERY DISEASE SCREENING

17 TEST; AT-RISK ENROLLEE.—For purposes of para18 graph (1)(E): 

19 ‘‘(A) PERIPHERAL ARTERY DISEASE

20 SCREENING TEST.—The term ‘peripheral artery 

21 disease screening test’ means— 

22 ‘‘(i) noninvasive physiologic studies of 

23 extremity arteries (commonly referred to 

24 as ankle-brachial index testing); 


kjohnson on DSK79L0C42PROD with BILLS
18 

•HR 8615 IH

1 ‘‘(ii) arterial duplex scans of lower ex2 tremity arteries vascular; and 

3 ‘‘(iii) such other items and services as 

4 the Secretary determines, in consultation 

5 with relevant stakeholders, to be appro6 priate for screening for peripheral artery 

7 disease for at-risk enrollees. 

8 ‘‘(B) AT-RISK ENROLLEE.—The term ‘at9 risk enrollee’ means an individual enrolled in a 

10 group health plan or group or individual health 

11 insurance coverage— 

12 ‘‘(i) who is 65 years of age or older; 

13 ‘‘(ii) who is at least 50 years of age 

14 but not older than 64 years of age with 

15 risk factors for atherosclerosis (such as di16 abetes mellitus, a history of smoking, 

17 hyperlipidemia, and hypertension) or a 

18 family history of peripheral artery disease; 

19 ‘‘(iii) who is younger than 50 years of 

20 age with diabetes mellitus and one addi21 tional risk factor for atherosclerosis; or 

22 ‘‘(iv) with a known atherosclerotic dis23 ease in another vascular bed such as coro24 nary, carotid, subclavian, renal, or mesenVerDate Sep 11 2014 00:13 Nov 13, 2020 Jkt 019200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H8615.IH H8615

kjohnson on DSK79L0C42PROD with BILLS
19 

•HR 8615 IH

1 teric artery stenosis, or abdominal aortic 

2 aneurysm. 

3 ‘‘(C) FREQUENCY.—The Secretary shall, 

4 in consultation with appropriate organizations, 

5 establish standards regarding the frequency for 

6 peripheral artery disease screening tests de7 scribed in paragraph (1)(E) for purposes of 

8 coverage under this section. 

9 ‘‘(3) CLARIFICATION REGARDING BREAST CAN10 CER SCREENING, MAMMOGRAPHY, AND PREVENTION

11 RECOMMENDATIONS.—For the purposes of this Act, 

12 and for the purposes of any other provision of law, 

13 the current recommendations of the United States 

14 Preventive Service Task Force regarding breast can15 cer screening, mammography, and prevention shall 

16 be considered the most current other than those 

17 issued in or around November 2009. 

18 ‘‘(4) RULE OF CONSTRUCTION.—Nothing in 

19 this subsection shall be construed to prohibit a plan 

20 or issuer from providing coverage for services in ad21 dition to those recommended by the United States 

22 Preventive Services Task Force or to deny coverage 

23 for services that are not recommended by such Task 

24 Force.’’. 


kjohnson on DSK79L0C42PROD with BILLS
20 

•HR 8615 IH

1 (b) EFFECTIVE DATE.—The amendment made by 

2 subsection (a) shall apply with respect to plan years begin3 ning on or after January 1, 2022. 

4 SEC. 6. DISALLOWANCE OF PAYMENT FOR NONTRAUMATIC 

5 AMPUTATION SERVICES FURNISHED WITH6 OUT ANATOMICAL TESTING SERVICES. 

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

8 1395m) is amended by adding at the end the following 

9 new subsection: 

10 ‘‘(x) DISALLOWANCE OF PAYMENT FOR NONTRAU11 MATIC AMPUTATION SERVICES FURNISHED WITHOUT

12 ANATOMICAL TESTING SERVICES.— 

13 ‘‘(1) IN GENERAL.—In the case of nontrau14 matic amputation services furnished by a supplier on 

15 or after January 1, 2022, to an individual entitled 

16 to, or enrolled for, benefits under part A and en17 rolled for benefits under this part, for which pay18 ment is made under this part, payment may only be 

19 made under this part if such supplier furnishes ana20 tomical testing services to such individual during the 

21 3-month period preceding the date on which such 

22 nontraumatic amputation services is furnished. 

23 ‘‘(2) DEFINITIONS.—In this subsection: 

24 ‘‘(A) ANATOMICAL TESTING SERVICES.— 

25 The term ‘anatomical testing services’ means 


kjohnson on DSK79L0C42PROD with BILLS
21 

•HR 8615 IH

1 arterial duplex scanning, computed tomography 

2 angiography, and magnetic resonance 

3 angiography. 

4 ‘‘(B) NONTRAUMATIC AMPUTATION SERV5 ICES.—The term ‘nontraumatic amputation 

6 services’ means amputations as a result of ath7 erosclerotic vascular disease or a related 

8 comorbity of such disease (including diabe9 tes).’’. 

10 SEC. 7. DEVELOPMENT AND IMPLEMENTATION OF QUALITY 

11 MEASURES. 

12 (a) DEVELOPMENT.—The Secretary of Health and 

13 Human Services (referred to in this section as the ‘‘Sec14 retary’’) shall, in consultation with relevant stakeholders, 

15 develop quality measures for nontraumatic, lower-limb, 

16 major amputation that utilize appropriate diagnostic 

17 screening (including peripheral artery disease screening) 

18 in order to encourage alternative treatments (including 

19 revascularization) in lieu of such an amputation. 

20 (b) IMPLEMENTATION.—After appropriate testing 

21 and validation of the measures developed under subsection 

22 (a), the Secretary shall incorporate such measures in qual23 ity reporting programs for appropriate providers of serv24 ices and suppliers under the Medicare program under title 


kjohnson on DSK79L0C42PROD with BILLS
22 

•HR 8615 IH

1 XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), 

2 including for purposes of— 

3 (1) the merit-based incentive payment system 

4 under section 1848(q) of such Act (42 U.S.C. 

5 1395w–4(q)); 

6 (2) incentive payments for participation in eligi7 ble alternative payment models under section 

8 1833(z) of such Act (42 U.S.C. 1395l(z)); 

9 (3) the shared savings program under section 

10 1899 of such Act (42 U.S.C. 1395jjj); 

11 (4) models under section 1115A of such Act 

12 (42 U.S.C. 1315a); and 

13 (5) such other payment systems or models as 

14 the Secretary may specify. 

Æ 


kjohnson on DSK79L0C42PROD with BILLS