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104TH CONGRESS

1ST SESSION H. R. 779

To amend title XVIII of the Social Security Act to provide for coverage

of prostate cancer screening tests under part B of the medicare program.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 1, 1995

Mrs. VUCANOVICH introduced the following bill; which was referred to the

Committee on 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

for coverage of prostate cancer screening tests under

part B of the medicare program.

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 ‘‘Medicare Prostate

5 Cancer Screening Act of 1995’’.

6 SEC. 2. FINDINGS.

7 Congress finds the following:
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1 (1) Prostate cancer is the second leading cause

2 of cancer death among men.

3 (2) An estimated 244,000 new cases of prostate

4 cancer in the United States are expected during

5 1995.

6 (3) An estimated 40,400 men are expected to

7 die of prostate cancer during 1995.

8 (4) The incidence of prostate cancer increases

9 with age and over 80 percent of all prostate cancers

10 are diagnosed in men over age 65.

11 (5) Early detection of prostate cancer is the

12 best way to control its growth and treat the tumors.

13 (6) Survival rates for prostate cancer have

14 steadily improved from 50 percent to 80 percent in

15 the past 30 years largely due to increases in the

16 early detection of the disease.

17 (7) The American Cancer Society and other

18 health organizations recommend an annual digital

19 rectal examination for men starting at age 40 and

20 an annual prostate-specific antigen blood test start21 ing at age 50.

22 SEC. 3. MEDICARE COVERAGE OF PROSTATE CANCER

23 SCREENING TESTS.

24 (a) IN GENERAL.—Section 1861(s)(2) of the Social

25 Security Act (42 U.S.C. 1395x(s)(2)), as amended by sec-
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1 tion 147(f)(6)(B)(iii) of the Social Security Act Amend2 ments of 1994, is amended—

3 (1) by striking ‘‘and’’ at the end of subpara4 graph (N); and

5 (2) by inserting after subparagraph (O) the fol6 lowing new subparagraph:

7 ‘‘(P) prostate cancer screening tests (as defined

8 in subsection (oo));’’.

9 (b) TESTS DESCRIBED.—Section 1861 of such Act

10 (42 U.S.C. 1395x) is amended by adding at the end the

11 following new subsection:

12 ‘‘Prostate Cancer Screening Tests

13 ‘‘(oo) The term ‘prostate cancer screening test’

14 means a test that consists of a digital rectal examination

15 or a prostate-specific antigen blood test (or both) provided

16 for the purpose of early detection of prostate cancer to

17 a man over 40 years of age who has not had such a test

18 during the preceding year.’’.

19 (c) PAYMENT FOR PROSTATE-SPECIFIC ANTIGEN

20 BLOOD TEST UNDER CLINICAL DIAGNOSTIC LABORA21 TORY TEST FEE SCHEDULES.—Section 1833(h)(1)(A) of

22 such Act (42 U.S.C. 1395l(h)(1)(A)) is amended by in23 serting after ‘‘laboratory tests’’ the following: ‘‘(including

24 prostate cancer screening tests under section 1861(oo)

25 consisting of prostate-specific antigen blood tests)’’.
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1 (d) CONFORMING AMENDMENT.—Section 1862(a) of

2 such Act (42 U.S.C. 1395y(a)) is amended—

3 (1) in paragraph (1)—

4 (A) in subparagraph (E), by striking

5 ‘‘and’’ at the end,

6 (B) in subparagraph (F), by striking the

7 semicolon at the end and inserting ‘‘, and’’, and

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

9 subparagraph:

10 ‘‘(G) in the case of prostate cancer screening

11 test (as defined in section 1861(oo)) provided for the

12 purpose of early detection of prostate cancer, which

13 are performed more frequently than is covered under

14 such section;’’; and

15 (2) in paragraph (7), by striking ‘‘paragraph

16 (1)(B) or under paragraph (1)(F)’’ and inserting

17 ‘‘subparagraphs (B), (F), or (G) of paragraph (1)’’.

18 SEC. 4. EFFECTIVE DATE.

19 The amendments made by section 3 shall apply to

20 tests furnished on or after January 1, 1996.

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