‘‘(5) LIMITING CHARGES OF NONPARTICIPATING
PHYSICIANS.—
‘‘(A) IN
GENERAL.—In the case of a
colorectal cancer screening test consisting of a
screening flexible sigmoidoscopy or a screening
colonoscopy provided to an individual at high
risk for colorectal cancer for which payment
may 
be 
made 
under 
this 
part, 
if 
a
nonparticipating physician provides the proce-
dure to an individual enrolled under this part,
the physician may not charge the individual
more than the limiting charge (as defined in
section 1848(g)(2)).
‘‘(B) ENFORCEMENT.—If a physician or
supplier knowing and willfully imposes a charge
in violation of subparagraph (A), the Secretary
may apply sanctions against such physician or
supplier 
in 
accordance 
with 
section
1842(j)(2).’’.
(2) SPECIAL
RULE
FOR
SCREENING
BARIUM
ENEMA.—If the Secretary of Health and Human
Services issues a determination under subsection
(a)(3) that screening barium enema should be cov-
ered as a colorectal cancer screening test under sec-
tion 1861(oo) of the Social Security Act (as added
by subsection (a)(2)), the Secretary shall establish
frequency limits (including revisions of frequency
limits) for such procedure consistent with the fre-
quency limits for other colorectal cancer screening
tests under section 1834(d) of such Act (as added
by paragraph (1)), and shall establish payment lim-
its (including limits on charges of nonparticipating
physicians) for such procedure consistent with the
payment limits under part B of title XVIII of such
Act for diagnostic barium enema procedures.
(c) CONFORMING AMENDMENTS.—(1) Paragraphs
(1)(D) and (2)(D) of section 1833(a) of such Act (42
U.S.C. 1395l(a)) are each amended by striking ‘‘sub-
section (h)(1),’’ and inserting ‘‘subsection (h)(1) or section
1834(d)(1),’’.
(2) Section 1833(h)(1)(A) of such Act (42 U.S.C.
1395l(h)(1)(A)) is amended by striking ‘‘The Secretary’’
and inserting ‘‘Subject to paragraphs (1) and (4)(A) of
section 1834(d), the Secretary’’.
(3) Clauses (i) and (ii) of section 1848(a)(2)(A) of
such Act (42 U.S.C. 1395w–4(a)(2)(A)) are each amended
by striking ‘‘a service’’ and inserting ‘‘a service (other
than a colorectal cancer screening test consisting of a
screening colonoscopy provided to an individual at high
risk for colorectal cancer or a screening flexible
sigmoidoscopy)’’.
(4) Section 1862(a) of such Act (42 U.S.C. 1395y(a))
is amended—
(A) in paragraph (1)—
(i) in subparagraph (E), by striking ‘‘and’’
at the end,
(ii) in subparagraph (F), by striking the
semicolon at the end and inserting ‘‘, and’’, and
(iii) by adding at the end the following new
subparagraph:
‘‘(G) in the case of colorectal cancer screening
tests, which are performed more frequently than is
covered under section 1834(d);’’; and
(B) in paragraph (7), by striking ‘‘paragraph
(1)(B) or under paragraph (1)(F)’’ and inserting
‘‘subparagraphs (B), (F), or (G) of paragraph (1)’’.
SEC. 5. PROSTATE CANCER SCREENING TESTS.
(a) IN GENERAL.—Section 1861(s)(2) of the Social
Security Act (42 U.S.C. 1395x(s)(2)), as amended by sec-
tion 4(a)(1), is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (P);
(2) by adding ‘‘and’’ at the end of subpara-
graph (Q); and
(3) by adding at the end the following new sub-
paragraph:
‘‘(R) prostate cancer screening tests (as defined
in subsection (pp)); and’’.
(b) TESTS DESCRIBED.—Section 1861 of such Act
(42 U.S.C. 1395x), as amended by section 4(a)(2), is
amended by adding at the end the following new sub-
section:
‘‘Prostate Cancer Screening Tests
‘‘(pp)(1) The term ‘prostate cancer screening test’
means a test that consists of any (or all) of the procedures
described in paragraph (2) provided for the purpose of
early detection of prostate cancer to a man over 50 years
of age who has not had such a test during the preceding
year.
‘‘(2) The procedures described in this paragraph are
as follows:
‘‘(A) A digital rectal examination.
‘‘(B) A prostate-specific antigen blood test.
‘‘(C) For years beginning after 1998, such
other procedures as the Secretary finds appropriate
for the purpose of early detection of prostate cancer,
taking into account changes in technology and
standards of medical practice, availability, effective-
ness, costs, and such other factors as the Secretary
considers appropriate.’’.
(c) PAYMENT
FOR PROSTATE-SPECIFIC ANTIGEN
BLOOD TEST UNDER CLINICAL DIAGNOSTIC LABORA-
TORY TEST FEE SCHEDULES.—Section 1833(h)(1)(A) of
such Act (42 U.S.C. 1395l(h)(1)(A)) is amended by in-
serting after ‘‘laboratory tests’’ the following: ‘‘(including
prostate cancer screening tests under section 1861(pp)
consisting of prostate-specific antigen blood tests)’’.
(d) CONFORMING AMENDMENT.—Section 1862(a) of
such Act (42 U.S.C. 1395y(a)), as amended by section
4(c)(4), is amended—
(1) in paragraph (1)—
(A) in subparagraph (F), by striking
‘‘and’’ at the end,
(B) in subparagraph (G), by striking the
semicolon at the end and inserting ‘‘, and’’, and
(C) by adding at the end the following new
subparagraph:
‘‘(H) in the case of prostate cancer screening
tests (as defined in section 1861(oo)), which are per-
formed more frequently than is covered under such
section;’’; and
(2) in paragraph (7), by striking ‘‘or (G)’’ and
inserting ‘‘(G), or (H)’’.
SEC. 6. DIABETES SCREENING BENEFITS.
(a) DIABETES
OUTPATIENT
SELF-MANAGEMENT
TRAINING SERVICES.—
(1) IN
GENERAL.—Section 1861(s)(2) of the
Social Security Act (42 U.S.C. 1395x(s)(2)), as
amended by sections 4(a)(1) and 5(a), is amended—
(A) by striking ‘‘and’’ at the end of sub-
paragraph (Q);
(B) by adding ‘‘and’’ at the end of sub-
paragraph (R); and
(C) by adding at the end the following new
subparagraph:
‘‘(S) diabetes outpatient self-management train-
ing services (as defined in subsection (qq)); and’’.
(2) DEFINITION.—Section 1861 of such Act
(42 U.S.C. 1395x), as amended by sections 4(a)(2)
and 5(b), is amended by adding at the end the fol-
lowing new subsection:
‘‘DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING
SERVICES
‘‘(qq)(1) The term ‘diabetes outpatient self-manage-
ment training services’ means educational and training
services furnished to an individual with diabetes by or
under arrangements with a certified provider (as described
in paragraph (2)(A)) in an outpatient setting by an indi-
vidual or entity who meets the quality standards described