I 

117TH CONGRESS 

1ST SESSION H. R. 3517 

To amend title XVIII of the Social Security Act to improve access to, 

and utilization of, bone mass measurement benefits under part B of 

the Medicare program by establishing a minimum payment amount under 

such part for bone mass measurement. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 25, 2021 

Mr. LARSON of Connecticut (for himself, Mrs. WALORSKI, Ms. SA ́NCHEZ, Mr. 

BURGESS, and Mrs. TRAHAN) 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 improve 

access to, and utilization of, bone mass measurement 

benefits under part B of the Medicare program by establishing a minimum payment amount under such part 

for bone mass measurement. 

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. SHORT TITLE. 

2 This Act may be cited as the ‘‘Increasing Access to 

3 Osteoporosis Testing for Medicare Beneficiaries Act of 

4 2021’’. 

5 SEC. 2. FINDINGS. 

6 The Congress finds the following: 

7 (1) The total annual expense of providing care 

8 for osteoporotic fractures among Medicare bene9 ficiaries, including direct medical costs as well as in10 direct societal costs related to productivity losses 

11 and informal caregiving, has been estimated at $57 

12 billion in 2018, with an expected increase to over 

13 $95 billion in 2040. 

14 (2) Osteoporosis is a silent disease that often is 

15 not discovered until a fracture occurs. One out of 

16 two women and up to one of four men will suffer an 

17 osteoporotic fracture in their lifetimes. 

18 (3) Osteoporosis disproportionately impacts 

19 women, who account for 71 percent of osteoporotic 

20 fractures, and 75 percent of costs. 

21 (4) Most women are not aware of their personal 

22 risk factors for osteoporosis, the prevalence of, or 

23 the morbidity and mortality associated with the dis24 ease, despite the fact that broken bones due to 

25 osteoporosis lead to more hospitalizations and greatVerDate Sep 11 2014 22:36 Jun 23, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3517.IH H3517

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1 er health care costs than heart attack, stroke, or 

2 breast cancer in women age 55 and above. 

3 (5) A woman’s risk of hip fracture is equal to 

4 her combined risk of breast, uterine, and ovarian 

5 cancer. More women die in the United States in the 

6 year following a hip fracture than from breast can7 cer. 

8 (6) One out of four people who have an 

9 osteoporotic hip fracture will need long-term nursing 

10 home care. Half of those who experience osteoporotic 

11 hip fractures are unable to walk without assistance. 

12 (7) Nearly one in five Medicare patients die 

13 within one year of a new osteoporotic fracture. 

14 Beneficiaries with a hip fracture had the highest 

15 mortality where approximately 30 percent died with16 in 12 months of the fracture. 

17 (8) Bone density testing is more powerful in 

18 predicting fractures than cholesterol is in predicting 

19 myocardial infarction or blood pressure in predicting 

20 stroke. 

21 (9) Since 2007, Medicare has cut DXA reim22 bursement by over 72 percent. By 2019, the pay23 ment cuts caused a loss of 44 percent of DXA office 

24 providers resulting in declines in expected DXA testVerDate Sep 11 2014 22:36 Jun 23, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3517.IH H3517

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1 ing, leaving 1.65 million women undiagnosed and 

2 untreated for osteoporosis. 

3 (10) A decade of steady decline in hip fractures 

4 stopped abruptly in 2013. As of 2019, there have 

5 been more than 71,775 additional hip fractures, 

6 costing almost $3 billion, leading to almost 16,000 

7 additional deaths than expected if the decline had 

8 continued. 

9 (11) An estimated 205,000 Medicare Fee For 

10 Service beneficiaries, or about 15 percent of those 

11 who had a new osteoporotic fracture, suffered one or 

12 more subsequent fractures within 12 months of the 

13 initial fracture. 

14 SEC. 3. INCREASING ACCESS TO OSTEOPOROSIS PREVEN15 TION AND TREATMENT. 

16 Section 1848(b) of the Social Security Act (42 U.S.C. 

17 1395w–4(b)) is amended— 

18 (1) in paragraph (4)(B)— 

19 (A) by striking ‘‘and the first 2 months of 

20 2012’’ and inserting ‘‘the first 2 months of 

21 2012, and 2022 and each subsequent year’’; 

22 and 

23 (B) by striking ‘‘paragraph (6)’’ and in24 serting ‘‘paragraphs (6) and (12)’’; and 

25 (2) by adding at the end the following: 


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1 ‘‘(12) ESTABLISHING MINIMUM PAYMENT FOR

2 OSTEOPOROSIS TESTS.—For dual-energy x-ray 

3 absorptiometry services (identified by HCPCS codes 

4 77080 and 77082 and successor codes 77085 and 

5 77086 (and any succeeding codes)) furnished during 

6 2022 or a subsequent year, the Secretary shall es7 tablish a national minimum payment amount under 

8 this subsection— 

9 ‘‘(A) for such services identified by 

10 HCPCS code 77080, equal to $98 (with na11 tional minimum payment amounts of $87.11 for 

12 the technical component and $10.89 for the 

13 professional component); 

14 ‘‘(B) for such services identified by 

15 HCPCS code 77086, equal to $35 (with na16 tional minimum payment amounts of $27.18 for 

17 the technical component and $7.82 for the pro18 fessional component); and 

19 ‘‘(C) for the bundled code for dual energy 

20 absorptiometry and vertebral fracture assess21 ment studies identified as HCPCS code 77085, 

22 equal to $133 (with national minimum payment 

23 amounts of $114.29 for the technical compo24 nent and $18.71 for the professional compo25 nent). 


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1 Such minimum payment amounts shall be adjusted 

2 by the geographical adjustment factor established 

3 under subsection (e)(2) for the services for the re4 spective year.’’. 

Æ 


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