II 

109TH CONGRESS 

2D SESSION S. 3609 

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

of certain physician pathology services under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

JUNE 29, 2006 

Mrs. LINCOLN (for herself, Mr. THOMAS, Mr. BUNNING, and Mr. CONRAD) 

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 the treatment of certain physician pathology services 

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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Physician Pathology 

5 Services Continuity Act of 2006’’. 

6 SEC. 2. PERMANENT TREATMENT OF CERTAIN PHYSICIAN 

7 PATHOLOGY SERVICES UNDER MEDICARE. 

8 Section 1848(i) (42 U.S.C. 1395w–4(i)) is amended 

9 by adding at the end the following new paragraph: 


ycherry on PROD1PC64 with BILLS
2 

•S 3609 IS

1 ‘‘(4) TREATMENT OF CERTAIN PHYSICIAN PA2 THOLOGY SERVICES.— 

3 ‘‘(A) IN GENERAL.—With respect to serv4 ices furnished on or after January 1, 2007, if 

5 an independent laboratory furnishes the tech6 nical component of a physician pathology serv7 ice to a fee-for-service medicare beneficiary who 

8 is an inpatient or outpatient of a covered hos9 pital, the Secretary shall treat such component 

10 as a service for which payment shall be made 

11 to the laboratory under this section and not as 

12 an inpatient hospital service for which payment 

13 is made to the hospital under section 1886(d) 

14 or as a hospital outpatient service for which 

15 payment is made to the hospital under section 

16 1833(t). 

17 ‘‘(B) DEFINITIONS.—In this paragraph: 

18 ‘‘(i) COVERED HOSPITAL.— 

19 ‘‘(I) IN GENERAL.—The term 

20 ‘covered hospital’ means, with respect 

21 to an inpatient or outpatient, a hos22 pital that had an arrangement with 

23 an independent laboratory that was in 

24 effect as of July 22, 1999, under 

25 which a laboratory furnished the techVerDate Aug 31 2005 00:15 Jul 06, 2006 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3609.IS S3609

ycherry on PROD1PC64 with BILLS
3 

•S 3609 IS

1 nical component of physician pathol2 ogy services to fee-for-service medi3 care beneficiaries who were hospital 

4 inpatients or outpatients, respectively, 

5 and submitted claims for payment for 

6 such component to a carrier with a 

7 contract under section 1842 and not 

8 to the hospital. 

9 ‘‘(II) CHANGE IN OWNERSHIP

10 DOES NOT AFFECT DETERMINA11 TION.—A change in ownership with 

12 respect to a hospital on or after the 

13 date referred to in subclause (I) shall 

14 not affect the determination of wheth15 er such hospital is a covered hospital 

16 for purposes of such subclause. 

17 ‘‘(ii) FEE-FOR-SERVICE MEDICARE

18 BENEFICIARY.—The term ‘fee-for-service 

19 medicare beneficiary’ means an individual 

20 who is entitled to (or enrolled for) benefits 

21 under part A, or enrolled under this part, 

22 or both, but who is not enrolled in any of 

23 the following: 

24 ‘‘(I) A Medicare Advantage plan 

25 under part C. 


ycherry on PROD1PC64 with BILLS
4 

•S 3609 IS

1 ‘‘(II) A plan offered by an eligi2 ble organization under section 1876. 

3 ‘‘(III) A program of all-inclusive 

4 care for the elderly (PACE) under 

5 section 1894. 

6 ‘‘(IV) A social health mainte7 nance organization (SHMO) dem8 onstration project established under 

9 section 4018(b) of the Omnibus 

10 Budget Reconciliation Act of 1987 

11 (Public Law 100–203). 

12 ‘‘(C) REFERENCE.—For the provision re13 lated to the treatment of certain services fur14 nished prior to January 1, 2007, see section 

15 542 of the Medicare, Medicaid, and SCHIP 

16 Benefits Improvement and Protection Act of 

17 2000, as amended by section 732 of the Medi18 care Prescription Drug, Improvement, and 

19 Modernization Act of 2003.’’. 

Æ 


ycherry on PROD1PC64 with BILLS