I 

114TH CONGRESS 

1ST SESSION H. R. 2043 

To amend title XVIII of the Social Security Act to ensure the continued 

access of Medicare beneficiaries to diagnostic imaging services, and for 

other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 28, 2015 

Mr. OLSON (for himself, Ms. MCCOLLUM, Mr. ROSKAM, and Mr. NUNES) 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 ensure 

the continued access of Medicare beneficiaries to diagnostic imaging services, 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. 

4 This Act may be cited as the ‘‘Diagnostic Imaging 

5 Services Access Protection Act of 2015’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) Significant reimbursement cuts to the Medi2 care physician fee schedule should be based on de3 tailed empirical analysis data. 

4 (2) On multiple occasions since 2011, Congress 

5 has requested the Centers for Medicare & Medicaid 

6 Services (CMS) to provide the data used to establish 

7 its 2012 multiple procedure payment reduction to 

8 the professional component of imaging services. 

9 (3) CMS never provided the requested data to 

10 Congress. 

11 (4) Enactment of section 220(i) of Public Law 

12 113–93 on April 1, 2014, mandates the disclosure of 

13 CMS data used to determine its 2012 multiple pro14 cedure payment reduction to the professional compo15 nent of imaging services. 

16 (5) CMS acknowledged its responsibility to dis17 close this data in the Calendar Year 2015 Medicare 

18 Physician Fee Schedule Notice of Proposed Rule 

19 Making (NPRM) released on July 11, 2014, as well 

20 as in a letter from the Administrator on August 18, 

21 2014. 

22 (6) To date, CMS has not complied with the 

23 statutory mandate provided for in section 220(i) of 

24 Public Law 113–93. 


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1 SEC. 3. MEDICARE PAYMENT FOR IMAGING SERVICES. 

2 Section 1848(b)(4) of the Social Security Act (42 

3 U.S.C. 1395w–4(b)(4)) is amended by adding at the end 

4 the following new subparagraph: 

5 ‘‘(E) ELIMINATION OF APPLICATION OF

6 MULTIPLE PROCEDURE PAYMENT REDUC7 TION.— 

8 ‘‘(i) IN GENERAL.—The Secretary 

9 shall not apply a multiple procedure pay10 ment reduction policy to the professional 

11 component of imaging services— 

12 ‘‘(I) furnished on a date that is 

13 more than 60 days after the date of 

14 the enactment of this subparagraph 

15 and in the year in which this subpara16 graph is enacted; or 

17 ‘‘(II) furnished in any subsequent 

18 year that is prior to a year in which 

19 the Secretary conducts and publishes, 

20 as part of the Medicare Physician Fee 

21 Schedule Proposed Rule for a year, 

22 the empirical analysis described in 

23 clause (ii). 

24 ‘‘(ii) EMPIRICAL ANALYSIS DE25 SCRIBED.—The empirical analysis de26 scribed in this clause is an analysis of the 


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1 Resource-Based Relative Value Scale (com2 monly known as the ‘RBRVS’) Data Man3 ager information that is used to determine 

4 what, if any, efficiencies exist within the 

5 professional component of imaging services 

6 when two or more studies are performed 

7 on the same patient on the same day. Such 

8 empirical analysis shall include— 

9 ‘‘(I) work sheets and other infor10 mation detailing which physician work 

11 activities performed given the typical 

12 vignettes were assigned reduction per13 centages of 0, 25, 50, 75 and 100 

14 percent; 

15 ‘‘(II) a discussion of the clinical 

16 aspects that informed the assignment 

17 of the reduction percentages described 

18 in subclause (I); 

19 ‘‘(III) an explanation of how the 

20 percentage reductions for pre-, intra21 and post-service work were deter22 mined and calculated; and 

23 ‘‘(IV) a demonstration that the 

24 Centers for Medicare & Medicaid 

25 Services has consulted with practicing 


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1 radiologists to gain knowledge of how 

2 radiologists interpret studies of mul3 tiple body parts on the same indi4 vidual on the same day.’’. 

Æ 


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