I 

114TH CONGRESS 

1ST SESSION H. R. 2550 

To amend title XVIII of the Social Security Act to provide Medicare payment 

incentives to transition from traditional x-ray imaging to digital radiography, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 21, 2015 

Mrs. MCMORRIS RODGERS 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 provide 

Medicare payment incentives to transition from traditional x-ray imaging to digital radiography, 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 ‘‘Medical Imaging Mod5 ernization Act of 2015’’. 

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1 SEC. 2. MEDICARE PAYMENT INCENTIVE FOR THE TRANSI2 TION FROM TRADITIONAL X-RAY IMAGING TO 

3 DIGITAL RADIOGRAPHY AND OTHER MEDI4 CARE IMAGING PAYMENT PROVISION. 

5 (a) PHYSICIAN FEE SCHEDULE.— 

6 (1) PAYMENT INCENTIVE FOR TRANSITION.— 

7 (A) IN GENERAL.—Section 1848(b) of the 

8 Social Security Act (42 U.S.C. 1395w–4(b)) is 

9 amended by adding at the end the following 

10 new paragraph: 

11 ‘‘(9) SPECIAL RULE TO INCENTIVIZE TRANSI12 TION FROM TRADITIONAL X-RAY IMAGING TO DIG13 ITAL RADIOGRAPHY.— 

14 ‘‘(A) LIMITATION ON PAYMENT FOR FILM

15 X-RAY IMAGING SERVICES.—In the case of im16 aging services that are X-rays taken using film 

17 and that are furnished during 2017 or a subse18 quent year, the payment amount for the tech19 nical component (including the technical compo20 nent portion of a global fee) of such services 

21 that would otherwise be determined under this 

22 section (without application of this paragraph 

23 and before application of any other adjustment 

24 under this section) for such year shall be re25 duced by 20 percent. 

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1 ‘‘(B) PHASED-IN LIMITATION ON PAYMENT

2 FOR COMPUTED RADIOGRAPHY IMAGING SERV3 ICES.—In the case of imaging services that are 

4 X-rays taken using computed radiography tech5 nology— 

6 ‘‘(i) in the case of such services fur7 nished during 2018, 2019, 2020, 2021, or 

8 2022 the payment amount for the tech9 nical component (including the technical 

10 component portion of a global fee) of such 

11 services that would otherwise be deter12 mined under this section (without applica13 tion of this paragraph and before applica14 tion of any other adjustment under this 

15 section) for such year shall be reduced by 

16 7 percent; and 

17 ‘‘(ii) in the case of such services fur18 nished during 2023 or a subsequent year, 

19 the payment amount for the technical com20 ponent (including the technical component 

21 portion of a global fee) of such services 

22 that would otherwise be determined under 

23 this section (without application of this 

24 paragraph and before application of any 

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1 other adjustment under this section) for 

2 such year shall be reduced by 10 percent. 

3 ‘‘(C) COMPUTED RADIOGRAPHY TECH4 NOLOGY DEFINED.—For purposes of this para5 graph, the term ‘computed radiography tech6 nology’ means cassette-based imaging which 

7 utilizes an imaging plate to create the image in8 volved. 

9 ‘‘(D) IMPLEMENTATION.—In order to im10 plement this paragraph, the Secretary shall 

11 adopt appropriate mechanisms which may in12 clude use of modifiers.’’. 

13 (B) EXEMPTION FROM BUDGET NEU14 TRALITY.—Section 1848(c)(2)(B)(v) of the So15 cial Security Act (42 U.S.C. 1395w– 

16 4(c)(2)(B)(v)) is amended, by adding at the end 

17 the following new subclause: 

18 ‘‘(X) REDUCED EXPENDITURES

19 ATTRIBUTABLE TO INCENTIVES TO

20 TRANSITION TO DIGITAL RADIOG21 RAPHY.—Effective for fee schedules 

22 established beginning with 2017, re23 duced expenditures attributable to 

24 subparagraph (A) of subsection (b)(9) 

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1 lished beginning with 2018, reduced 

2 expenditures attributable to subpara3 graph (B) of such subsection.’’. 

4 (2) ELIMINATION OF APPLICATION OF MUL5 TIPLE PROCEDURE PAYMENT REDUCTION.—Section 

6 1848(b)(4) of the Social Security Act (42 U.S.C. 

7 1395w–4(b)(4)) is amended by adding at the end 

8 the following new subparagraph: 

9 ‘‘(E) ELIMINATION OF APPLICATION OF

10 MULTIPLE PROCEDURE PAYMENT REDUC11 TION.— 

12 ‘‘(i) IN GENERAL.—Not later than 

13 January 1, 2016, the Secretary shall not 

14 apply a multiple procedure payment reduc15 tion policy to the professional component 

16 of imaging services furnished in any subse17 quent year that is prior to a year in which 

18 the Secretary conducts and publishes, as 

19 part of the Medicare Physician Fee Sched20 ule Proposed Rule for a year, the empirical 

21 analysis described in clause (ii). 

22 ‘‘(ii) EMPIRICAL ANALYSIS DE23 SCRIBED.—The empirical analysis de24 scribed in this clause is an analysis of the 

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1 monly known as the ‘RBRVS’) Data Man2 ager information that is used to determine 

3 what, if any, efficiencies exist within the 

4 professional component of imaging services 

5 when two or more studies are performed 

6 on the same patient on the same day. Such 

7 empirical analysis shall include— 

8 ‘‘(I) work sheets and other infor9 mation detailing which physician work 

10 activities performed given the typical 

11 vignettes were assigned reduction per12 centages of 0, 25, 50, 75 and 100 

13 percent; 

14 ‘‘(II) a discussion of the clinical 

15 aspects that informed the assignment 

16 of the reduction percentages described 

17 in subclause (I); 

18 ‘‘(III) an explanation of how the 

19 percentage reductions for pre-, intra 

20 and post-service work were deter21 mined and calculated; and 

22 ‘‘(IV) a demonstration that the 

23 Centers for Medicare & Medicaid 

24 Services has consulted with practicing 

25 radiologists to gain knowledge of how 

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1 radiologists interpret studies of mul2 tiple body parts on the same indi3 vidual on the same day.’’. 

4 (b) PAYMENT INCENTIVE FOR TRANSITION UNDER

5 HOSPITAL OUTPATIENT PROSPECTIVE PAYMENT SYS6 TEM.—Section 1833(t)(16) of the Social Security Act (42 

7 U.S.C. 1395(t)(16)) is amended by adding at the end the 

8 following new subparagraph: 

9 ‘‘(F) PAYMENT INCENTIVE FOR THE TRAN10 SITION FROM TRADITIONAL X-RAY IMAGING TO

11 DIGITAL RADIOGRAPHY.—Notwithstanding the 

12 previous provisions of this subsection: 

13 ‘‘(i) LIMITATION ON PAYMENT FOR

14 FILM X-RAY IMAGING SERVICES.—In the 

15 case of imaging services that are X-rays 

16 taken using film and that are furnished 

17 during 2017 or a subsequent year, the pay18 ment amount for the technical component 

19 (including the technical component portion 

20 of a global fee) of such services that would 

21 otherwise be determined under this section 

22 (without application of this paragraph and 

23 before application of any other adjustment 

24 under this subsection) for such year shall 

25 be reduced by 20 percent. 

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1 ‘‘(ii) PHASED-IN LIMITATION ON PAY2 MENT FOR COMPUTED RADIOGRAPHY IM3 AGING SERVICES.—In the case of imaging 

4 services that are X-rays taken using com5 puted radiography technology (as defined 

6 in section 1848(b)(9)(C))— 

7 ‘‘(I) in the case of such services 

8 furnished during 2018, 2019, 2020, 

9 2021, or 2022 the payment amount 

10 for the technical component (including 

11 the technical component portion of a 

12 global fee) of such services that would 

13 otherwise be determined under this 

14 section (without application of this 

15 paragraph and before application of 

16 any other adjustment under this sub17 section) for such year shall be reduced 

18 by 7 percent; and 

19 ‘‘(II) in the case of such services 

20 furnished during 2023 or a subse21 quent year, the payment amount for 

22 the technical component (including 

23 the technical component portion of a 

24 global fee) of such services that would 

25 otherwise be determined under this 

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1 section (without application of this 

2 paragraph and before application of 

3 any other adjustment under this sub4 section) for such year shall be reduced 

5 by 10 percent. 

6 ‘‘(iii) APPLICATION WITHOUT REGARD

7 TO BUDGET NEUTRALITY.—The reductions 

8 made under this paragraph— 

9 ‘‘(I) shall not be considered an 

10 adjustment under paragraph (2)(E); 

11 and 

12 ‘‘(II) shall not be implemented in 

13 a budget neutral manner.’’. 

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