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107TH CONGRESS

1ST SESSION H. R. 1568

To amend title XVIII of the Social Security Act to remove the restriction

on coverage of periodic health examinations under the Medicare Program.

IN THE HOUSE OF REPRESENTATIVES

APRIL 24, 2001

Mr. MCDERMOTT (for himself, Mrs. MINK of Hawaii, Mr. KLECZKA, Mr.

GILCHREST, Mr. FROST, Mr. BROWN of Ohio, Mr. FRANK, Mr. MATSUI,

Mr. BRADY of Pennsylvania, Mr. WEXLER, Ms. RIVERS, Mr. BONIOR,

Mr. HINCHEY, Mr. MOAKLEY, Mr. EVANS, Mr. BOUCHER, Mr. SANDERS,

Mr. CLAY, Ms. CARSON of Indiana, Mr. KUCINICH, Mr. RUSH, Mr.

STARK, Mr. BALDACCI, Mr. SANDLIN, Mrs. THURMAN, Mr. LAFALCE,

Mr. MCGOVERN, Mr. STUPAK, Mr. KILDEE, Mr. LATOURETTE, Mr.

GEORGE MILLER of California, Mr. HILLIARD, and Mr. MORAN of Virginia) 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 remove

the restriction on coverage of periodic health examinations under the Medicare Program.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. REMOVAL OF MEDICARE RESTRICTION ON

2 COVERAGE OF PERIODIC HEALTH EXAMINA3 TIONS.

4 (a) COVERAGE.—Section 1861(s)(2) of the Social Se5 curity Act (42 U.S.C. 395x(s)(2)), as amended by sections

6 102(a) and 105(a) of the Medicare, Medicaid, and SCHIP

7 Benefits Improvement and Protection Act of 2000, as en8 acted into law by section 1(a)(6) of Public Law 106–554,

9 is amended—

10 (1) in subparagraph (U), by striking ‘‘and’’ at

11 the end;

12 (2) in subparagraph (V), by inserting ‘‘and’’ at

13 the end; and

14 (3) by adding at the end the following new sub15 paragraph:

16 ‘‘(W) periodic health examinations (as de17 fined in subsection (vv));’’.

18 (b) SERVICES DESCRIBED.—Section 1861 of such

19 Act (42 U.S.C. 1395x), as amended by section 102(b) of

20 the Medicare, Medicaid, and SCHIP Benefits Improve21 ment and Protection Act of 2000, as enacted into law by

22 section 1(a)(6) of Public Law 106–554, is amended by

23 adding at the end the following new subsection:

24 ‘‘Periodic Health Examinations

25 ‘‘(vv) The term ‘periodic health examination’ means

26 a comprehensive examination performed by a physician
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1 conducted on a periodic basis, with the content and fre2 quency determined by the physician, in accordance with

3 regulations of the Secretary, with the goal of health pro4 motion and disease detection. Such an examination

5 includes—

6 ‘‘(1) a thorough history and physical examina7 tion;

8 ‘‘(2) a review of systems;

9 ‘‘(3) monitoring of chronic conditions;

10 ‘‘(4) counseling for risky behaviors;

11 ‘‘(5) appropriate referrals (including to cancer

12 screening interventions); and

13 ‘‘(6) ancillary services.’’.

14 (c) PAYMENT AS PHYSICIANS’ SERVICES.—Section

15 1848(j)(3) of such Act (42 U.S.C. 1395w–4(j)(3)) is

16 amended by inserting ‘‘(2)(V),’’ after ‘‘(2)(S),’’.

17 (d) OTHER CONFORMING AMENDMENTS.—Section

18 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended—

19 (1) in paragraph (1)—

20 (A) by striking ‘‘and’’ at the end of sub21 paragraph (H),

22 (B) by adding ‘‘and’’ at the end of sub23 paragraph (I), and

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

25 subparagraph:
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1 ‘‘(J) in the case of periodic health examina2 tions, which are performed more frequently than is

3 covered under section 1861(vv);’’; and

4 (2) in paragraph (7), by striking ‘‘or (H)’’ and

5 inserting ‘‘(H), or (J)’’.

6 (e) EFFECTIVE DATE.—The amendments made by

7 this section shall apply to services furnished on or after

8 January 1, 2002.

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