I 
114TH CONGRESS 
2D SESSION 
H. R. 4632 
To amend title XVIII of the Social Security Act to cover screening computed 
tomography colonography as a colorectal cancer screening test under 
the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 25, 2016 
Mr. WENSTRUP (for himself and Mr. DANNY K. DAVIS of Illinois) 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 com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to cover 
screening computed tomography colonography as a 
colorectal cancer screening test under the Medicare pro-
gram. 
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 ‘‘CT Colonography 
Screening for Colorectal Cancer Act of 2016’’. 
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SEC. 
2. 
COVERAGE 
OF 
COMPUTED 
TOMOGRAPHY 
COLONOGRAPHY 
SCREENING 
AS 
A 
COLORECTAL 
CANCER 
SCREENING 
TEST 
UNDER MEDICARE. 
(a) IN GENERAL.—Section 1861(pp)(1) of the Social 
Security Act (42 U.S.C. 1395x(pp)(1)) is amended— 
(1) by redesignating subparagraph (D) as sub-
paragraph (E); and 
(2) by inserting after subparagraph (C) the fol-
lowing new subparagraph: 
‘‘(D) 
Screening 
computed 
tomography 
colonography.’’. 
(b) FREQUENCY LIMITS
AND PAYMENT.—Section 
1834(d) of such Act (42 U.S.C. 1395m(d)) is amended 
by adding at the end the following new paragraph: 
‘‘(4) 
SCREENING
COMPUTED
TOMOGRAPHY 
COLONOGRAPHY.— 
‘‘(A) FEE SCHEDULE.—With respect to a 
colorectal cancer screening test consisting of 
screening computed tomography colonography, 
subject to subparagraph (B), payment under 
section 1848 shall be consistent with payment 
under such section for similar or related serv-
ices. 
‘‘(B) PAYMENT
LIMIT.—In the case of 
screening computed tomography colonography, 
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payment under this part shall not exceed such 
amount as the Secretary specifies, based upon 
rates recognized for diagnostic computed to-
mography colonography. 
‘‘(C) FACILITY PAYMENT LIMIT.—Notwith-
standing any other provision of this title, in the 
case of an individual who receives screening 
computed tomography colonography— 
‘‘(i) in computing the amount of any 
applicable coinsurance, the computation of 
such coinsurance shall be based upon the 
fee schedule under which payment is made 
for the services; and 
‘‘(ii) the amount of such coinsurance 
shall not exceed 25 percent of the payment 
amount under the fee schedule described in 
subparagraph (A). 
‘‘(D) FREQUENCY
LIMIT.—No payment 
may be made under this part for a colorectal 
cancer screening test consisting of a screening 
computed tomography colonography— 
‘‘(i) if the individual is under 50 years 
of age; or 
‘‘(ii)(I) in the case of individuals at 
high risk for colorectal cancer, if the proce-
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dure is performed within the 23 months 
after a previous screening computed to-
mography colonography or a previous 
screening colonoscopy; or 
‘‘(II) in the case of an individual who 
is not at high risk for colorectal cancer, if 
the procedure is performed within the 119 
months 
after 
a 
previous 
screening 
colonoscopy or within the 59 months after 
a previous screening flexible sigmoidoscopy 
or a previous screening computed tomog-
raphy colonography.’’. 
(c) CONFORMING FREQUENCY LIMITS FOR OTHER 
COLORECTAL CANCER SCREENING TESTS.— 
(1) SCREENING
FLEXIBLE
SIGMOIDOSCOPY.— 
Paragraph (2)(E)(ii) of section 1834(d) of the Social 
Security Act (42 U.S.C. 1395m(d)) is amended by 
inserting 
‘‘or 
screening 
computed 
tomography 
colonography’’ after ‘‘previous screening flexible 
sigmoidoscopy’’. 
(2) 
SCREENING
COLONOSCOPY.—Paragraph 
(3)(E) of such section is amended— 
(A) by inserting ‘‘or screening computed 
tomography colonography’’ after ‘‘23 months 
after a previous screening colonoscopy’’; and 
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(B) by inserting ‘‘or screening computed 
tomography colonography’’ after ‘‘screening 
flexible sigmoidoscopy’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2017. 
SEC. 3. EXEMPTION OF SCREENING COMPUTED TOMOG-
RAPHY 
COLONOGRAPHY 
FROM 
SPECIAL 
RULE ON PAYMENT FOR IMAGING SERVICES. 
(a) IN GENERAL.—Section 1848(b)(4)(B) of the So-
cial Security Act (42 U.S.C. 1395w–4(b)(4)(B)) is amend-
ed by inserting ‘‘and screening computed tomography 
colonography’’ after ‘‘diagnostic and screening mammog-
raphy’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to items and services furnished 
on or after January 1, 2017. 
SEC. 4. REPORTS ON THE STATUS OF COVERING COM-
PUTED TOMOGRAPHY COLONOGRAPHY AS A 
COLORECTAL 
CANCER 
SCREENING 
TEST 
UNDER MEDICARE. 
(a) PRELIMINARY REPORT.—Not later than 90 days 
after the date of the enactment of this Act, the Secretary 
of Health and Human Services shall submit a preliminary 
report to Congress on the status of coverage of computed 
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tomography colonography as a colorectal cancer screening 
test under the Medicare program under title XVIII of the 
Social Security Act, including the extent to which such 
coverage as required by the amendments made by sections 
2 and 3 has been implemented. 
(b) ANNUAL REPORT.—Not later than September 30 
of each fiscal year during the 5-year period beginning with 
fiscal year 2018, the Secretary shall submit to the Con-
gress, a status report on the following: 
(1) The impact of screening computed tomog-
raphy colonography on the change in colorectal can-
cer screening compliance of Medicare beneficiaries. 
(2) The various utilization rates with respect to 
Medicare beneficiaries for each available colorectal 
cancer screening option before and after the avail-
ability of and coverage of screening computed to-
mography colonography under the Medicare program 
pursuant to the enactment of this Act, including— 
(A) by initial CRC screening performed 
with respect to a Medicare beneficiary per year, 
including the age of the beneficiary when the 
initial screening was performed; and 
(B) by follow-on screening performed, 
whereby the analysis demonstrates to what ex-
tent 
screening 
computed 
tomography 
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colonography was used as a substitute for a 
previous screening procedure. 
(3) Access to screening computed tomography 
colonography by Medicare beneficiaries, especially in 
rural areas or underserved populations, before and 
after the date of implementation of coverage of such 
screening benefit under the Medicare program pur-
suant to the enactment of this Act. 
(4) Recommendations for such legislation and 
administrative action as the Secretary determines 
appropriate to implement this Act. 
Æ 
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