I 

114TH CONGRESS 

1ST SESSION H. R. 2461 

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 

MAY 20, 2015 

Mr. BURGESS (for himself, Mr. LARSON of Connecticut, Mrs. BLACKBURN, 

and Ms. LINDA T. SA ́NCHEZ of California) 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 (2002– 

14 2008), 41 percent of older female Medicare bene15 ficiaries had no DXA bone density test, and 25 per16 cent had only 1 test. 

17 (10) DXA testing in older women declined in 

18 2012 to the lowest point in 8 years. 

19 SEC. 2. INCREASING ACCESS TO OSTEOPOROSIS PREVEN20 TION AND TREATMENT. 

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

22 1395w–4(b)) is amended— 

23 (1) in paragraph (4)(B), by striking ‘‘and the 

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


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1 months of 2012, 2016, and each subsequent year’’; 

2 and 

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

4 ‘‘(8) ESTABLISHING MINIMUM PAYMENT FOR

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

6 absorptiometry services (identified by HCPCS codes 

7 77080 and 77082 and successor codes 77085 and 

8 77086 (and any succeeding codes)) furnished during 

9 2016 or a subsequent year, the Secretary shall es10 tablish a national minimum payment amount under 

11 this subsection— 

12 ‘‘(A) for such services identified by 

13 HCPCS code 77080, equal to $98 (with na14 tional minimum payment amounts of $87.11 for 

15 the technical component and $10.89 for the 

16 professional component); and 

17 ‘‘(B) for such services identified by 

18 HCPCS code 77086, equal to $35 (with na19 tional minimum payment amounts of $27.18 for 

20 the technical component and $7.82 for the pro21 fessional component); 

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

23 absorptiometry and vertebral fracture assess24 ment studies identified as HCPCS code 77085, 

25 equal to $133 (with national minimum payment 


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1 amounts of $114.29 for the technical compo2 nent and $18.71 for the professional compo3 nent). 

4 Such minimum payment amounts shall be adjusted 

5 by the geographical adjustment factor established 

6 under subsection (e)(2) for the services for the re7 spective year.’’. 

Æ 


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