II 

108TH CONGRESS 

2D SESSION S. 2553 

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

of screening ultrasound for abdominal aortic aneurysms under part B 

of the medicare program. 

IN THE SENATE OF THE UNITED STATES 

JUNE 21, 2004 

Mr. DASCHLE (for Mr. DODD (for himself and Mr. BUNNING)) introduced the 

following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for coverage of screening ultrasound for abdominal aortic 

aneurysms 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 ‘‘Screening Abdominal 

5 Aortic Aneurysms Very Efficiently Act of 2004’’. 
2 

•S 2553 IS 

1 SEC. 2. MEDICARE COVERAGE OF SCREENING 

2 ULTRASOUND FOR ABDOMINAL AORTIC AN3 EURYSMS. 

4 (a) IN GENERAL.—Section 1861 of the Social Secu5 rity Act (42 U.S.C. 1395x), as amended by sections 611, 

6 612, 613, 642, and 706 of the Medicare Prescription 

7 Drug, Improvement, and Modernization Act of 2003 (Pub8 lic Law 108–173), is amended— 

9 (1) in subsection (s)(2)— 

10 (A) by striking ‘‘and’’ at the end of sub11 paragraph (Y); 

12 (B) by adding ‘‘and’’ at the end of sub13 paragraph (Z); and 

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

15 subparagraph: 

16 ‘‘(AA) screening ultrasound for abdominal aor17 tic aneurysm (as defined in subsection (bbb)) for an 

18 individual who has not been previously furnished 

19 such a screening ultrasound and who— 

20 ‘‘(i) has a family history of abdominal aor21 tic aneurysm; 

22 ‘‘(ii) manifests risk factors for cardio23 vascular disease (such as smoking or hyper24 tension); 

25 ‘‘(iii) evidences arthrosclerotic vascular dis26 ease; or 
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1 ‘‘(iv) has other risk factors for abdominal 

2 aortic aneurysm as the Secretary may specify;’’; 

3 and 

4 (2) by adding at the end the following new sub5 section: 

6 ‘‘Screening Ultrasound for Abdominal Aortic Aneurysm 

7 ‘‘(bbb) The term ‘screening ultrasound for abdominal 

8 aortic aneurysm’ means— 

9 ‘‘(1) a procedure using sound waves (or such 

10 other procedures using alternative technologies, of 

11 commensurate accuracy and cost, that the Secretary 

12 may specify) provided for the early detection of ab13 dominal aortic aneurysm, and 

14 ‘‘(2) includes a physician’s interpretation of the 

15 results of the procedure.’’. 

16 (b) INCLUSION OF SCREENING ULTRASOUND FOR

17 ABDOMINAL AORTIC ANEURYSM IN SCREENING SERVICES

18 FOR WHICH EDUCATION, COUNSELING, AND REFERRAL

19 IS PROVIDED FOR UNDER BENEFITS FOR INITIAL PRE20 VENTIVE PHYSICAL EXAMINATION.—Section 1861(ww)(2) 

21 of the Social Security Act (42 U.S.C. 1395x(ww)(2)), as 

22 added by section 611(b) of the Medicare Prescription 

23 Drug, Improvement, and Modernization Act of 2003 (Pub24 lic Law 108–173), is amended by adding at the end the 

25 following new subparagraph: 
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1 ‘‘(L) Screening ultrasound for abdominal aortic 

2 aneurysm as defined in section 1861(bbb).’’. 

3 (c) PAYMENT FOR SCREENING ULTRASOUND FOR

4 ABDOMINAL AORTIC ANEURYSM.—Section 1848(j)(3) of 

5 the Social Security Act (42 U.S.C. 1395w–4(j)(3)) is 

6 amended by inserting ‘‘(2)(AA)’’ after ‘‘(2)(W)’’. 

7 (d) FREQUENCY AND QUALITY STANDARDS.—Sec8 tion 1862(a)(1) of such Act (42 U.S.C. 1395m(a)(1)), as 

9 amended by sections 303, 611, 612, and 613 of the Medi10 care Prescription Drug, Improvement, and Modernization 

11 Act of 2003, is amended— 

12 (1) by striking ‘‘and’’ at the end of subpara13 graph (L); 

14 (2) by striking the semicolon at the end of sub15 paragraph (M) and inserting ‘‘; and’’; and 

16 (3) by adding at the end the following new sub17 paragraph: 

18 ‘‘(N) in the case of screening ultrasound for ab19 dominal aortic aneurysm— 

20 ‘‘(i) which is performed more frequently 

21 than is provided for under section 

22 1861(s)(2)(AA); or 

23 ‘‘(ii) which is performed by an individual 

24 or diagnostic laboratory that does not meet 

25 quality assurance standards established by the 
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1 Secretary, including with respect to individuals 

2 performing screening ultrasound for abdominal 

3 aortic aneurysm (other than physicians) and di4 agnostic laboratories, that the individual or lab5 oratory is certified by the appropriate State li6 censing or certification agency or, in the case of 

7 service performed in a State that does not li8 cense or certify such individuals or laboratories, 

9 by a national certification or accreditation orga10 nization recognized by the Secretary.’’. 

11 (e) NON-APPLICATION OF PART B DEDUCTIBLE.— 

12 Section 1833(b) of such Act (42 U.S.C. 1395l(b)) is 

13 amended— 

14 (1) by striking ‘‘and’’ after ‘‘section 1861(jj)),’’; 

15 and 

16 (2) by inserting ‘‘, and (7) such deductible shall 

17 not apply with respect to screening ultrasound for 

18 abdominal aortic aneurysm (as defined in section 

19 1861(bbb))’’ after ‘‘1861(nn))’’. 

20 (f) CONSULTATION IN ESTABLISHMENT OF QUALITY

21 ASSURANCE STANDARDS AND DESIGNATION OF RECOGNI22 TION OF NATIONAL ACCREDITATION ORGANIZATIONS.— 

23 The Secretary shall consult with national medical, vas24 cular technologist and sonographer societies in estab25 lishing— 
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1 (1) risk factors under section 1861(s)(2)(A)(iv) 

2 of the Social Security Act, as added by subsection 

3 (a)(1)(C), and 

4 (2) quality assurance standards under section 

5 1862(a)(1)(N)(ii) of such Act, as added by sub6 section (d)(3). 

7 (g) EFFECTIVE DATE.—The amendments made by 

8 this section shall apply to screening ultrasounds for ab9 dominal aortic aneurysm performed on or after January 

10 1, 2005. 

11 SEC. 3. NATIONAL EDUCATIONAL AND INFORMATION CAM12 PAIGN. 

13 (a) IN GENERAL.—After consultation with national 

14 medical, vascular technologist, and sonographer societies, 

15 the Secretary of Health and Human Services shall carry 

16 out a national education and information campaign to pro17 mote awareness among health care practitioners and the 

18 general public with respect to the importance of early de19 tection and treatment of abdominal aortic aneurysms. 

20 (b) USE OF FUNDS.—The Secretary may use 

21 amounts appropriated pursuant to this subsection to make 

22 grants to national medical, vascular technologist, and 

23 sonographer societies (in accordance with procedures and 

24 criteria specified by the Secretary) to enable them to edu-
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1 cate practitioners and providers about matters relating to 

2 such aneurysms. 

3 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

4 authorized to be appropriated for fiscal year 2005 and 

5 each fiscal year thereafter such sums as may be necessary 

6 to carry out this section. 

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