I 

108TH CONGRESS 

1ST SESSION H. R. 817

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

reimbursement under the Medicare Program for screening and diagnostic 

mammography services, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 13, 2003

Mr. KING of New York (for himself, Mr. HOBSON, Ms. SLAUGHTER, Mr. 

FOSSELLA, Ms. ROS-LEHTINEN, Mr. COSTELLO, Mr. TOWNS, Mr. 

HONDA, Mr. SOUDER, Mr. WALSH, Mr. TIBERI, Mr. BOEHLERT, Mr. 

LATOURETTE, Mr. NEAL of Massachusetts, Mr. GORDON, Mr. OBERSTAR, Mr. REYES, Ms. WOOLSEY, Mr. HINCHEY, Mr. STRICKLAND, Mr. 

MCHUGH, Mr. FROST, Mr. SWEENEY, Ms. CORRINE BROWN of Florida, 

Ms. NORTON, Mr. FORBES, Ms. BORDALLO, Mr. MCINTYRE, Mr. 

RODRIGUEZ, Mrs. CAPPS, Mr. FORD, Mr. MCNULTY, Mr. KILDEE, Mr. 

MEEHAN, Mr. DEUTSCH, Ms. MILLENDER-MCDONALD, Mr. BISHOP of 

New York, Mrs. MCCARTHY of New York, Mrs. CHRISTENSEN, Mr. 

TERRY, Mr. PASCRELL, Mr. SIMMONS, Mr. ABERCROMBIE, Mr. TAYLOR

of Mississippi, Mr. GUTIERREZ, Mr. LOBIONDO, Mr. PAYNE, Mr. RANGEL, Mr. DAVIS of Illinois, Mr. DELAHUNT, Mr. SERRANO, Mrs. JO ANN

DAVIS of Virginia, Mr. ACKERMAN, Mrs. KELLY, Ms. LINDA T. SA ́NCHEZ

of California, Mr. NADLER, Mr. OWENS, Mr. ETHERIDGE, Mr. FARR, and 

Mr. GONZALEZ) 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 provide 

for enhanced reimbursement under the Medicare Pro-
2

•HR 817 IH 

gram for screening and diagnostic mammography services, 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 ‘‘Assure Access to Mam5 mography Act of 2003’’. 

6 SEC. 2. ENHANCED REIMBURSEMENT UNDER THE MEDI7 CARE PROGRAM FOR SCREENING AND DIAG8 NOSTIC MAMMOGRAPHY SERVICES FUR9 NISHED IN 2003. 

10 (a) PAYMENTS TO FACILITIES FOR SCREENING AND

11 DIAGNOSTIC MAMMOGRAPHY.—

12 (1) IN GENERAL.—Notwithstanding any other 

13 provision of law, with respect to payment for a 

14 screening or diagnostic mammography furnished to 

15 a medicare beneficiary, the amount of payment made 

16 to a hospital-based facility (defined in paragraph 

17 (4)) in which such screening or diagnostic mammog18 raphy is performed during the applicable period de19 scribed in paragraph (3) is equal to 200 percent of 

20 the amount of payment that would otherwise apply 

21 under the fee schedule established under section 

22 1848 of the Social Security Act (42 U.S.C. 1395w–

23 4) with respect to the technical component of such 

24 screening or diagnostic mammography. 
3

•HR 817 IH 

1 (2) TEMPORARY PAYMENT RULE.—With respect 

2 to payments to a hospital-based facility for screening 

3 or diagnostic mammography described in paragraph 

4 (1) during the applicable period, payment shall be 

5 made to the facility for such mammography pursu6 ant to this subsection and shall not be made under 

7 section 1833(t) of such Act (42 U.S.C. 1395l(t)). 

8 (3) APPLICABLE PERIOD.—The applicable pe9 riod referred to in paragraph (1) is the period begin10 ning on the date of the enactment of this Act and 

11 ending on the date the Secretary establishes and im12 plements an appropriate facility payment rate under 

13 the prospective payment system for covered out14 patient services under such section 1833(t) for a 

15 screening or diagnostic mammography furnished to 

16 a medicare beneficiary, but in no case less than the 

17 amount payment provided for in paragraph (1). 

18 (4) HOSPITAL-BASED FACILITY DEFINED.—In 

19 this subsection, the term ‘‘hospital-based facility’’ 

20 means a facility for which payment is made for a di21 agnostic or screening mammography under such sec22 tion 1833(t) but for this subsection. 

23 (b) NOT COUNTING CERTAIN RADIOLOGY RESI24 DENTS AGAINST GRADUATE MEDICAL EDUCATION LIMI25 TATIONS.—
4

•HR 817 IH 

1 (1) IN GENERAL.—For cost reporting periods 

2 beginning on or after October 1, 2003, and before 

3 October 1, 2008, in applying the limitations regard4 ing the total number of full-time equivalent residents 

5 in the field of allopathic or osteopathic medicine 

6 under subsections (d)(5)(B)(v) and (h)(4)(F) of sec7 tion 1886 of the Social Security Act (42 U.S.C. 

8 1395ww) for a hospital, the Secretary of Health and 

9 Human Services shall not take into account 1 addi10 tional resident in the field of radiology per post11 graduate year during each such cost reporting period 

12 to the extent the hospital increases the number of 

13 radiology residents above the number of such resi14 dents for the hospital’s most recent cost reporting 

15 period ending before October 1, 2003. 

16 (2) TREATMENT FOR ENTIRE PERIOD OF

17 TRAINING PROGRAM.—The provisions of paragraph 

18 (1) shall apply for each year of the full-time equiva19 lent resident’s approved medical residency training 

20 program in the field of radiology not taken into ac21 count by reason of paragraph (1). 

22 (c) CONSTRUCTION.—Nothing in this section shall be 

23 construed as affecting the provisions of section 104(d) of 

24 the Medicare, Medicaid, and SCHIP Benefits Improve25 ment and Protection Act of 2000 (as enacted into law by 
5

•HR 817 IH 

1 section 1(a)(6) of Public Law 106–554) (relating to pay2 ment for new technologies). 

3 SEC. 3. IOM STUDY AND REPORT ON MEDICARE REIM4 BURSEMENT FOR GENDER-SPECIFIC SERV5 ICES. 

6 (a) STUDY.—The Secretary of Health and Human 

7 Services shall enter into an arrangement with the Institute 

8 of Medicine of the National Academy of Sciences to con9 duct a study of—

10 (1) the relative value units established by the 

11 Secretary under the medicare physician fee schedule 

12 under section 1848 of the Social Security Act (42 

13 U.S.C. 1395w–4) for physicians’ services that are 

14 gender-specific; and 

15 (2) adjustments to payment amounts under the 

16 prospective payment systems for inpatient hospital 

17 services (under section 1886(d) of such Act (42 

18 U.S.C. 1395ww(d))) and for covered skilled nursing 

19 facility services (under section 1888(e) of such Act 

20 (42 U.S.C. 1395yy(e))) that are gender specific. 

21 (b) REPORT.—

22 (1) IN GENERAL.—Such arrangement shall pro23 vide that the Institute shall submit to the Secretary 

24 a report on the study conducted under subsection 

25 (a) by not later than December 31, 2004. 
6

•HR 817 IH 

1 (2) RECOMMENDATIONS.—The report shall in2 clude such recommendations regarding the appro3 priateness of adjusting the relative value units for 

4 physicians’ services or the prospective payment 

5 amounts for inpatient hospital services or covered 

6 skilled nursing facility services that are gender-spe7 cific, as the Institute determines appropriate. 

8 (3) TRANSMISSION TO CONGRESS.—The Sec9 retary shall promptly transmit a copy of such report 

10 to Congress. 

11 SEC. 4. MEDPAC STUDY AND REPORT ON MEDICARE REIM12 BURSEMENT FOR SCREENING SERVICES. 

13 (a) STUDY.—The Medicare Payment Advisory Com14 mission shall conduct a study of the relative value units 

15 established by the Secretary of Health and Human Serv16 ices under the medicare physician fee schedule under sec17 tion 1848 of the Social Security Act (42 U.S.C. 1395w–

18 4) for screening services that are reimbursed under such 

19 fee schedule. 

20 (b) REPORT.—Not later than March 1, 2004, the 

21 Commission shall submit to Congress a report on the 

22 study conducted under subsection (a), together with such 

23 recommendations regarding the appropriateness of adjust24 ing the relative value units for screening services that are 
7

•HR 817 IH 

1 reimbursed under the physician fee schedule as the Com2 mission determines appropriate.

Æ