I 
111TH CONGRESS 
1ST SESSION H. R. 3559 
To amend titles XVIII and XIX of the Social Security Act to improve 
awareness and access to colorectal cancer screening tests under the 
Medicare and Medicaid programs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 14, 2009 
Mr. NEAL of Massachusetts introduced the following bill; which was referred 
to the Committee on Energy and Commerce, and in addition to the Com-
mittee 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 titles XVIII and XIX of the Social Security Act 
to improve awareness and access to colorectal cancer 
screening tests under the Medicare and Medicaid pro-
grams, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Supporting ColoRectal 
Examination and Education Now (SCREEN) Act of 
2009’’. 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
SEC. 2. FINDINGS AND SENSE OF CONGRESS. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) A majority of the deaths and costs associ-
ated with colorectal cancer, the second leading cause 
of cancer deaths in the United States, are avoidable 
through 
timely 
preventive 
screening, 
including 
colonoscopy. 
(2) The United States Preventive Services Task 
Force provides its only grade ‘‘A’’ recommendation 
of cancer screenings for colorectal interventions. 
(3) Colorectal cancer screening test rates are 
far too low, with only 50 percent of recommended 
populations receiving colorectal cancer screening 
tests, and rates of such screening tests among mi-
norities and those without insurance lag consider-
ably. 
(4) The colorectal cancer screening benefit 
under the Medicare program under title XVIII of 
the Social Security Act is severely underutilized. 
(5) Numerous barriers for patients, commu-
nities, and health care providers detrimentally affect 
the utilization of colorectal cancer screening tests. 
Such barriers include patient knowledge, coinsurance 
burdens, restrictions on Medicare coverage for an of-
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
fice visit prior to a screening colonoscopy, and reduc-
tions in Medicare reimbursement. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that— 
(1) if legislation to provide health insurance 
coverage, public or private, to persons under the age 
of 65, is enacted, coverage of colorectal cancer 
screening tests and the provisions of this Act should 
be included as part of any basic benefit package re-
quired under such legislation; and 
(2) Congress, Federal agencies, State and local 
governments, health care providers, and patient 
groups should make a concerted and sustained effort 
to increase the rate of colorectal cancer screening 
tests. 
SEC. 3. COMMUNITY AND PATIENT INTERVENTIONS. 
(a) GRANT PROGRAM TO INCREASE COLORECTAL 
CANCER AWARENESS, SCREENING, AND TREATMENT.— 
(1) DEFINITIONS.—In this subsection: 
(A) 
COLORECTAL
CANCER
SCREENING 
TESTS.—The term ‘‘colorectal cancer screening 
test’’ has the meaning given such term in sec-
tion 1861(pp)(1) of the Social Security Act (42 
U.S.C. 1395x(pp)(1)). 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
(B) INDIAN
TRIBE.—The term ‘‘Indian 
tribe’’ has the meaning given such term in sec-
tion 4 of the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 450b). 
(C) SECRETARY.—The term ‘‘Secretary’’ 
means the Secretary of Health and Human 
Services, acting through the Director of the 
Centers for Disease Control and Prevention. 
(D) STATE.—The term ‘‘State’’ means— 
(i) a State; and 
(ii) the District of Columbia. 
(2) GRANTS
AUTHORIZED.—The Secretary is 
authorized to make grants to States and Indian 
tribes for colorectal health programs. Such a pro-
gram may include the following: 
(A) The provision of colorectal cancer 
screening tests, including colonoscopy, to indi-
viduals who are over 50 years of age or who are 
determined to be at high risk for such cancer. 
(B) The provision of case management and 
referrals for medical treatment for individuals 
who are provided colorectal cancer screening 
tests under the program. 
(C) Programs to ensure that individuals 
who are provided colorectal cancer screening 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
(1) DEFINITIONS.—In this subsection: 
(A) 
COLORECTAL
CANCER
SCREENING 
TESTS.—The term ‘‘colorectal cancer screening 
test’’ has the meaning given such term in sec-
tion 1861(pp)(1) of the Social Security Act (42 
U.S.C. 1395x(pp)(1)). 
(B) MEDICARE BENEFICIARY.—The term 
‘‘Medicare beneficiary’’ means an individual en-
titled to, or enrolled for, benefits under part A 
of title XVIII of the Social Security Act and en-
rolled for benefits under part B of such title. 
(C) SECRETARY.—The term ‘‘Secretary’’ 
means the Secretary of Health and Human 
Services. 
(2) ANNUAL NOTIFICATION UNDER THE MEDI-
CARE
PROGRAM.—The Secretary shall establish a 
program under which all Medicare beneficiaries are 
notified annually about the coverage of colorectal 
cancer screening tests under the Medicare program 
under title XVIII of the Social Security Act. Under 
the program, such notification— 
(A) may be provided through direct mail or 
direct electronic communications; and 
(B) may accompany other information cur-
rently provided to such beneficiaries, including 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
marketing materials or information provided to 
enrollees by Medicare Advantage organizations 
under section 1852(c)(1) of the Social Security 
Act (42 U.S.C. 1395w–22) and information 
provided by PDP sponsors under section 
1860D–4(a)(1) of such Act (42 U.S.C. 1395w– 
104(a)(1)). 
(3) STATE
PLAN
AMENDMENT
UNDER
MED-
ICAID.— 
(A) IN GENERAL.—Section 1902(a) of the 
Social Security Act (42 U.S.C. 1396a(a)), as 
amended by section 5006(e)(2)(A) of division B 
of the American Recovery and Reinvestment 
Act of 2009 (Public Law 111–5), is amended— 
(i) in paragraph (72), by striking 
‘‘and’’ at the end; 
(ii) in paragraph (73)(B), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
(iii) by inserting after paragraph (73), 
the following new paragraph: 
‘‘(74) if the State has elected to provide medical 
assistance described in section 1905(a)(13) and such 
assistance includes colorectal cancer screening tests, 
provide for the establishment of a program under 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
which individuals at risk for colon cancer, including 
minorities who are identified as at high-risk for 
colon cancer, who are over an age that the Secretary 
determines appropriate (based on the recommenda-
tions of appropriate entities, including the United 
States Preventive Services Task Force and appro-
priate medical specialty societies) are provided a no-
tification of the availability of medical assistance for 
colorectal cancer screening tests and a reminder re-
garding the benefits of such tests.’’. 
(B) EFFECTIVE DATE.— 
(i) IN GENERAL.—Except as provided 
in clause (ii), the amendments made by 
this paragraph take effect on January 1, 
2011. 
(ii) EXTENSION OF EFFECTIVE DATE 
FOR
STATE
LAW
AMENDMENT.—In the 
case of a State plan under title XIX of the 
Social Security Act (42 U.S.C. 1396 et 
seq.) which the Secretary of Health and 
Human Services determines requires State 
legislation in order for the plan to meet the 
additional requirements imposed by the 
amendments made by this paragraph, the 
State plan shall not be regarded as failing 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
to comply with the requirements of such 
title solely on the basis of its failure to 
meet these additional requirements before 
the first day of the first calendar quarter 
beginning after the close of the first reg-
ular session of the State legislature that 
begins after the date of enactment of this 
Act. For purposes of the previous sentence, 
in the case of a State that has a 2-year 
legislative session, each year of the session 
is considered to be a separate regular ses-
sion of the State legislature. 
SEC. 4. ELIMINATION OF COINSURANCE FOR COLORECTAL 
CANCER SCREENING TESTS. 
(a) IN GENERAL.—Section 1833(a)(1) of the Social 
Security Act (42 U.S.C. 1395l(a)(1)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(W)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (X) with respect to colorectal 
cancer screening tests (as defined in subsection 
(pp)), the amount paid shall be 100 percent of the 
lesser of the actual charge for the services or the 
amount determined under the fee schedule that ap-
plies to such tests under this part’’. 
(b) CONFORMING AMENDMENTS.— 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
(1) 
SCREENING
SIGMOIDOSCOPIES
AND 
COLONOSCOPIES.—Section 1834(d) of the Social Se-
curity Act (42 U.S.C. 1395m(d)) is amended— 
(A) in paragraph (2)— 
(i) in subparagraph (A), by inserting 
‘‘, except that payment for such tests 
under such section shall be 100 percent of 
the payment determined under such sec-
tion for such tests’’ before the period at 
the end; and 
(ii) in subparagraph (C)— 
(I) by striking clause (ii); and 
(II) in clause (i)— 
(aa) by striking ‘‘(i) IN GEN-
ERAL.—Notwithstanding’’ 
and 
inserting ‘‘Notwithstanding’’; 
(bb) by redesignating sub-
clauses (I) and (II) as clauses (i) 
and (ii), respectively, and moving 
such clauses and the flush matter 
following such clauses 2 ems to 
the left; and 
(cc) in the flush matter fol-
lowing clause (ii), as so redesig-
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
nated, by inserting ‘‘100 percent 
of’’ after ‘‘based on’’; and 
(B) in paragraph (3)— 
(i) in subparagraph (A), by inserting 
‘‘, except that payment for such tests 
under such section shall be 100 percent of 
the payment determined under such sec-
tion for such tests’’ before the period at 
the end; and 
(ii) in subparagraph (C)— 
(I) by striking clause (ii); and 
(II) in clause (i)— 
(aa) by striking ‘‘(i) IN GEN-
ERAL.—Notwithstanding’’ 
and 
inserting ‘‘Notwithstanding’’; and 
(bb) by inserting ‘‘100 per-
cent of’’ after ‘‘based on’’. 
(2) OUTPATIENT HOSPITAL SETTINGS.—Section 
1833(t) of the Social Security Act (42 U.S.C. 
1395l(t)) is amended— 
(A) in paragraph (4)(C), by striking 
‘‘paragraph (8)(C)’’ and inserting ‘‘subpara-
graphs (C) and (F) of paragraph (8)’’; and 
(B) in paragraph (8), by adding at the end 
the following new subparagraph: 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
‘‘(F) NO
COPAYMENT
FOR
COLORECTAL 
CANCER
SCREENING
TESTS.—The copayment 
amount that would otherwise apply under this 
subsection to colorectal cancer screening tests 
(as defined in section 1861(pp)) shall be re-
duced to zero.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2010. 
SEC. 5. MEDICARE ADVANTAGE REPORTING REQUIRE-
MENTS. 
(a) IN GENERAL.—Section 1857(e) of the Social Se-
curity Act (42 U.S.C. 1395w–27(e)) is amended by adding 
at the end the following new paragraph: 
‘‘(4) 
ANNUAL
REPORTING
REGARDING 
COLORECTAL CANCER SCREENING TESTS.— 
‘‘(A) IN
GENERAL.—Not later than 6 
months after the date of enactment of this 
paragraph and annually thereafter, a contract 
under this section with an MA organization 
shall require the organization to submit to the 
Secretary an annual report on the following: 
‘‘(i) The coverage of colorectal cancer 
screening tests (as defined in section 
1861(pp)) under each MA plan offered by 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
the organization, including the level of any 
coinsurance or copayments applicable for 
enrollees under the plan. 
‘‘(ii) Any educational outreach the or-
ganization provides to enrollees, providers 
of services, and suppliers with respect to 
such tests. 
‘‘(iii) Any pay-for-performance incen-
tives under MA plans offered by the orga-
nization for providers of services and sup-
pliers with respect to such tests, or any 
other financial-sharing program with pro-
viders of services and suppliers with re-
spect to such tests. 
‘‘(iv) The total number of enrollees 
furnished such tests during the preceding 
year, listed according to the specific test 
furnished, the type of facility in which the 
test was furnished, and the gender and 
race of the enrollees to whom such tests 
were furnished. 
‘‘(B) REPORT TO CONGRESS AND PUBLIC 
AVAILABILITY.— 
‘‘(i) REPORT.—The Secretary shall 
submit to Congress an annual report con-
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
taining information submitted in the cor-
responding annual report under subpara-
graph (A). 
‘‘(ii) 
PUBLIC
AVAILABILITY.—The 
Secretary shall make such information 
available to the public, including by posting 
such information on the Internet website of 
the Centers for Medicare & Medicaid Serv-
ices.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to contracts entered into on or 
after January 1, 2011. 
SEC. 6. PROVIDER INTERVENTIONS. 
(a) IN GENERAL.—Section 1834(d) of the Social Se-
curity Act (42 U.S.C. 1395m(d)) is amended by adding 
at the end the following new paragraph: 
‘‘(4) PREVENTIVE SERVICE PAYMENT MODIFIED 
FOR
CERTAIN
COLORECTAL
CANCER
SCREENING 
TESTS.— 
‘‘(A) NATIONAL
MINIMUM
STANDARDS.— 
The Secretary, in consultation with the Insti-
tute of Medicine, shall establish a national min-
imum standard for basic knowledge, training, 
continuing education, and documentation for 
suppliers who furnish colorectal cancer screen-
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
ing tests (as defined in subsection (pp)). For 
purposes of this paragraph, a supplier shall be 
deemed to meet such national minimum stand-
ards if the supplier is certified in gastro-
enterology by the American Board of Internal 
Medicine. 
‘‘(B) 
PREVENTIVE
SERVICE
PAYMENT 
MODIFIER.— 
‘‘(i) 
DETERMINATION
OF
RATE 
GOALS.—The Secretary, in consultation 
with the United States Preventive Services 
Task Force, the Institute of Medicine 
Colorectal Cancer Working Group, and 
other clinical advisors as determined ap-
propriate by the Secretary, shall determine 
age-based goal rates for colorectal cancer 
screening tests (as so defined) to be met or 
exceeded for beneficiaries under this part 
not later than July 1, 2010. Such age- 
based goal rates shall be consistent with 
the rates of screening for beneficiaries with 
respect to other cancer screening tests 
(such as screening mammography and cer-
vical cancer screening). 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
‘‘(ii) ESTABLISHMENT
OF
PREVEN-
TIVE SERVICE MODIFIER FOR QUALIFIED 
COLORECTAL
CANCER
SCREENING 
TESTS.— 
‘‘(I) IN
GENERAL.—The Sec-
retary shall establish an upward pre-
ventive service payment modifier for 
qualifying colorectal cancer screening 
tests furnished on or after January 1, 
2010, which reflects the annual deter-
mination by the Secretary of the ap-
propriate amount of additional pay-
ment (not less than 10 percent of the 
amount of payment otherwise pro-
vided) sufficient to increase the rate 
of colorectal cancer screening tests 
furnished under this part to the goal 
rates determined under clause (i). The 
Secretary shall update such modifier 
on an annual basis, taking into con-
sideration the rate of colorectal cancer 
screening tests furnished under this 
part during the preceding year and 
such goal rates. 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
‘‘(II) QUALIFYING
COLORECTAL 
CANCER
SCREENING
TESTS.—For 
purposes of subclause (I), the term 
‘qualifying colorectal cancer screening 
tests’ 
means 
a 
colorectal 
cancer 
screening test furnished by a supplier 
who meets the national minimum 
standards established under subpara-
graph (A) (as determined by the Sec-
retary).’’. 
(b) OUTPATIENT SETTINGS.—Section 1833(t) of the 
Social Security Act (42 U.S.C. 1395l(t)) is amended by 
adding at the end the following new paragraph: 
‘‘(18) IN GENERAL.— 
‘‘(A) NATIONAL
MINIMUM
STANDARDS.— 
The Secretary, in consultation with the Insti-
tute of Medicine, shall establish a national min-
imum standard for basic knowledge, training, 
continuing education, and documentation for 
hospitals in outpatient settings which furnish 
colorectal cancer screening tests (as defined in 
subsection (pp)). For purposes of this para-
graph, a hospital shall be deemed to meet such 
national minimum standards if the hospital is 
certified by the Joint Commission on the Ac-
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
creditation of Healthcare Organizations, the Ac-
creditation Association for Ambulatory Health 
Care, or other accreditation body designated by 
the Secretary. 
‘‘(B) 
PREVENTIVE
SERVICE
PAYMENT 
MODIFIER.— 
‘‘(i) 
DETERMINATION
OF
RATE 
GOALS.—The Secretary, in consultation 
with the United States Preventive Services 
Task Force, the Institute of Medicine 
Colorectal Cancer Working Group, and 
other clinical advisors as determined ap-
propriate by the Secretary, shall determine 
age-based goal rates for colorectal cancer 
screening tests (as so defined) to be met or 
exceeded for beneficiaries under this part 
not later than July 1, 2010. Such age- 
based goal rates shall be consistent with 
the rates of screening for beneficiaries with 
respect to other cancer screening tests 
(such as screening mammography and cer-
vical cancer screening). 
‘‘(ii) ESTABLISHMENT
OF
PREVEN-
TIVE SERVICE MODIFIER FOR QUALIFIED 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
COLORECTAL
CANCER
SCREENING 
TESTS.— 
‘‘(I) IN
GENERAL.—The Sec-
retary shall establish an upward pre-
ventive service payment modifier for 
qualifying colorectal cancer screening 
tests furnished on or after January 1, 
2010, which reflects the annual deter-
mination by the Secretary of the ap-
propriate amount of additional pay-
ment (not less than 10 percent of the 
amount of payment otherwise pro-
vided) sufficient to increase the rate 
of colorectal cancer screening tests 
furnished under this part to the goal 
rates determined under clause (i). The 
Secretary shall update such modifier 
on an annual basis, taking into con-
sideration the rate of colorectal cancer 
screening tests furnished under this 
part during the preceding year and 
such goal rates. 
‘‘(II) QUALIFYING
COLORECTAL 
CANCER
SCREENING
TESTS.—For 
purposes of subclause (I), the term 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
‘qualifying colorectal cancer screening 
tests’ 
means 
a 
colorectal 
cancer 
screening test furnished by a hospital 
in an outpatient setting which meets 
the national minimum standards es-
tablished under subparagraph (A) (as 
determined by the Secretary).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2010. 
SEC. 7. COVERAGE FOR AN OFFICE VISIT OR CONSULTA-
TION PRIOR TO A QUALIFYING SCREENING 
COLONOSCOPY. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (DD), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (EE), by inserting ‘‘and’’ 
at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(FF) an outpatient office visit or consultation 
for the purpose of beneficiary education, assuring se-
lection of the proper screening test, and securing in-
formation relating to the procedure and sedation of 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
the beneficiary, prior to a colorectal cancer screening 
test consisting of a screening colonoscopy or in con-
junction with the beneficiary’s decision to obtain 
such a screening, regardless of whether such screen-
ing is medically indicated with respect to the bene-
ficiary;’’. 
(b) PAYMENT.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by section 4, is amended— 
(A) by striking ‘‘and’’ before ‘‘(W)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (Y) with respect 
to an outpatient office visit or consultation 
under section 1861(s)(2)(BB), the amounts 
paid shall be 80 percent of the lesser of the ac-
tual charge or the amount established under 
section 1848’’. 
(2) PAYMENT UNDER PHYSICIAN FEE SCHED-
ULE.—Section 1848(j)(3) of the Social Security Act 
(42 U.S.C. 1395w–4(j)(3)) is amended by inserting 
‘‘(2)(FF),’’ after ‘‘(2)(EE),’’. 
(3) REQUIREMENT
FOR
ESTABLISHMENT
OF 
PAYMENT AMOUNT UNDER PHYSICIAN FEE SCHED-
ULE.—Section 1834(d) of the Social Security Act 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS
(42 U.S.C. 1395m(d)), as amended by section 6, is 
amended by adding at the end the following new 
paragraph: 
‘‘(5) PAYMENT FOR OUTPATIENT OFFICE VISIT 
OR
CONSULTATION
PRIOR
TO
SCREENING 
COLONOSCOPY.—With respect to an outpatient office 
visit or consultation under section 1861(s)(2)(BB), 
payment under section 1848 shall be consistent with 
the payment amounts for CPT codes 99203 and 
99243.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2010. 
Æ 
VerDate Nov 24 2008 
01:59 Sep 15, 2009
Jkt 079200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6301
E:\BILLS\H3559.IH
H3559
wwoods2 on DSK1DXX6B1PROD with BILLS