I 

110TH CONGRESS 

1ST SESSION H. R. 4879 

To amend title XVIII of the Social Security Act to include screening computed 

tomography colonography as a colorectal screening test for purposes 

of coverage under the Medicare Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 19, 2007 

Mrs. CUBIN (for herself and Mr. TOWNS) 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 include 

screening computed tomography colonography as a 

colorectal screening test for purposes of coverage under 

the Medicare Program, 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 ‘‘Virtual Screening for 

5 Cancer Act of 2007’’. 


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1 SEC. 2. SCREENING COMPUTED TOMOGRAPHY 

2 COLONOGRAPHY INCLUDED AS A 

3 COLORECTAL SCREENING TEST FOR PUR4 POSES OF COVERAGE UNDER THE MEDICARE 

5 PROGRAM. 

6 (a) IN GENERAL.—Section 1861(pp)(1) of the Social 

7 Security Act (42 U.S.C. 1395x(pp)(1)) is amended— 

8 (1) by redesignating subparagraph (D) as sub9 paragraph (E); and 

10 (2) by inserting after subparagraph (C) the fol11 lowing new subparagraph: 

12 ‘‘(D) Screening computed tomography 

13 colonography.’’. 

14 (b) FREQUENCY LIMITS AND PAYMENT FOR SCREEN15 ING COMPUTED TOMOGRAPHY COLONOGRAPHY.—Section 

16 1834(d) of the Social Security Act (42 U.S.C. 1395m(d)) 

17 is amended by adding at the end the following new para18 graph: 

19 ‘‘(4) SCREENING COMPUTED TOMOGRAPHY

20 COLONOGRAPHY.— 

21 ‘‘(A) FEE SCHEDULE.—With respect to a 

22 colorectal cancer screening test consisting of 

23 screening computed tomography colonography, 

24 payment under section 1848 shall be consistent 

25 with payment under such section for similar or 

26 related services. 


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1 ‘‘(B) PAYMENT LIMIT.—In the case of 

2 screening computed tomography colonography, 

3 payment under this part shall not exceed such 

4 amount as the Secretary specifies, based upon 

5 rates recognized for diagnostic computed to6 mography colonography. 

7 ‘‘(C) FACILITY PAYMENT LIMIT.— 

8 ‘‘(i) IN GENERAL.—Notwithstanding 

9 subsections (i)(2)(A) and (t) of section 

10 1833, in the case of screening computed 

11 tomography colonography furnished on or 

12 after January 1, 2008, that— 

13 ‘‘(I) in accordance with regula14 tions, may be performed in an ambu15 latory surgical center and for which 

16 the Secretary permits ambulatory sur17 gical center payments under this part; 

18 and 

19 ‘‘(II) are performed in an ambu20 latory surgical center or hospital out21 patient department, 

22 payment under this part shall be based on 

23 the lesser of the amount under the fee 

24 schedule that would apply to such services 

25 if they were performed in a hospital outVerDate Aug 31 2005 03:30 Dec 22, 2007 Jkt 069200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4879.IH H4879

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1 patient department in an area or the 

2 amount under the fee schedule that would 

3 apply to such services if they were per4 formed in an ambulatory surgical center in 

5 the same area. 

6 ‘‘(ii) LIMITATION ON COINSURANCE.— 

7 Notwithstanding any other provision of 

8 this title, in the case of a beneficiary who 

9 receives the services described in clause 

10 (i)— 

11 ‘‘(I) in computing the amount of 

12 any applicable copayment, the com13 putation of such coinsurance shall be 

14 based upon the fee schedule under 

15 which payment is made for the serv16 ices; and 

17 ‘‘(II) the amount of such coinsur18 ance shall not exceed 25 percent of 

19 the payment amount under the fee 

20 schedule described in subclause (I). 

21 ‘‘(D) FREQUENCY LIMIT.—No payment 

22 may be made under this part for a colorectal 

23 cancer screening test consisting of a screening 

24 computed tomography colonography— 


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1 ‘‘(i) if the individual is under 50 years 

2 of age; or 

3 ‘‘(ii)(I) in the case of individuals at 

4 high risk for colorectal cancer, if the proce5 dure is performed within the 23 months 

6 after a previous screening computed to7 mography colonography or a previous 

8 screening colonoscopy; or 

9 ‘‘(II) in the case of an individual who 

10 is not at high risk for colorectal cancer, if 

11 the procedure is performed within the 119 

12 months after a previous screening 

13 colonoscopy or within the 47 months after 

14 a previous screening flexible sigmoidoscopy 

15 or a previous screening computed tomog16 raphy colonography.’’. 

17 (c) CONFORMING FREQUENCY LIMITS FOR OTHER

18 COLORECTAL CANCER SCREENING TESTS.— 

19 (1) SCREENING FLEXIBLE SIGMOIDOSCOPY.— 

20 Paragraph (2)(E)(ii) of section 1834(d) of the Social 

21 Security Act (42 U.S.C. 1395m(d)) is amended by 

22 inserting ‘‘or screening computed tomography 

23 colonography’’ after ‘‘previous screening flexible 

24 sigmoidoscopy’’. 


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1 (2) SCREENING COLONOSCOPY.—Paragraph 

2 (3)(E) of such section is amended— 

3 (A) by inserting ‘‘or screening computed 

4 tomography colonography’’ after ‘‘23 months 

5 after a previous screening colonoscopy’’; and 

6 (B) by inserting ‘‘or screening computed 

7 tomography colonography’’ after ‘‘screening 

8 flexible sigmoidoscopy’’. 

9 (d) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to items and services furnished on 

11 or after January 1, 2009. 

12 SEC. 3. EXEMPTION OF SCREENING COMPUTED TOMOG13 RAPHY COLONOGRAPHY FROM SPECIAL 

14 RULE ON IMAGING SERVICES. 

15 (a) IN GENERAL.—Section 1848(b)(4)(B) of the So16 cial Security Act (42 U.S.C. 1395w–4(b)(4)(B)) is amend17 ed by inserting ‘‘and screening computed tomography 

18 colonography’’ after ‘‘diagnostic and screening mammog19 raphy’’. 

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

21 subsection (a) shall apply to items and services furnished 

22 on or after January 1, 2009. 

Æ 


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