I 
112TH CONGRESS 
1ST SESSION H. R. 2461 
To amend title XVIII of the Social Security Act to provide for the treatment 
of certain physician pathology services under the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 8, 2011 
Mr. DAVIS of Kentucky (for himself and Mr. ROSS of Arkansas) 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 provide 
for the treatment of certain physician pathology services 
under the Medicare Program. 
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 ‘‘Physician Pathology 
Services Continuity Act of 2011’’. 
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SEC. 2. PERMANENT TREATMENT OF CERTAIN PHYSICIAN 
PATHOLOGY SERVICES UNDER MEDICARE. 
Section 1848(i) of the Social Security Act (42 U.S.C. 
1395w–4(i)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(4) TREATMENT OF CERTAIN PHYSICIAN PA-
THOLOGY SERVICES.— 
‘‘(A) IN GENERAL.—With respect to serv-
ices furnished on or after January 1, 2012, if 
an independent laboratory furnishes the tech-
nical component of a physician pathology serv-
ice to a fee-for-service medicare beneficiary who 
is an inpatient or outpatient of a covered hos-
pital, the Secretary shall treat such component 
as a service for which payment shall be made 
to the laboratory under this section and not as 
an inpatient hospital service for which payment 
is made to the hospital under section 1886(d) 
or as a hospital outpatient service for which 
payment is made to the hospital under section 
1833(t). 
‘‘(B) DEFINITIONS.—In this paragraph: 
‘‘(i) COVERED HOSPITAL.— 
‘‘(I) IN
GENERAL.—The term 
‘covered hospital’ means, with respect 
to an inpatient or outpatient, a hos-
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pital that had an arrangement with 
an independent laboratory that was in 
effect as of July 22, 1999, under 
which a laboratory furnished the tech-
nical component of physician pathol-
ogy services to fee-for-service medi-
care beneficiaries who were hospital 
inpatients or outpatients, respectively, 
and submitted claims for payment for 
such component to a carrier with a 
contract under section 1842 and not 
to the hospital. 
‘‘(II) CHANGE
IN
OWNERSHIP 
DOES
NOT
AFFECT
DETERMINA-
TION.—A change in ownership with 
respect to a hospital on or after the 
date referred to in subclause (I) shall 
not affect the determination of wheth-
er such hospital is a covered hospital 
for purposes of such subclause. 
‘‘(ii) 
FEE-FOR-SERVICE
MEDICARE 
BENEFICIARY.—The term ‘fee-for-service 
medicare beneficiary’ means an individual 
who is entitled to (or enrolled for) benefits 
under part A, or enrolled under this part, 
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or both, but who is not enrolled in any of 
the following: 
‘‘(I) A Medicare Advantage plan 
under part C. 
‘‘(II) A plan offered by an eligi-
ble organization under section 1876. 
‘‘(III) A program of all-inclusive 
care for the elderly (PACE) under 
section 1894. 
‘‘(IV) A social health mainte-
nance organization (SHMO) dem-
onstration project established under 
section 4018(b) of the Omnibus 
Budget Reconciliation Act of 1987 
(Public Law 100–203). 
‘‘(C) REFERENCE.—For the treatment of 
certain physician pathology services furnished 
prior to January 1, 2012, see section 542 of the 
Medicare, Medicaid, and SCHIP Benefits Im-
provement and Protection Act of 2000, as ex-
tended by— 
‘‘(i) Centers for Medicare & Medicaid 
Services (CMS) Program Memorandum for 
Carriers (transmittal B–03–001), issued 
January 17, 2003; 
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‘‘(ii) CMS Manual System, Publica-
tion 100–20 One-Time Notification (trans-
mittal 34), issued December 24, 2003; 
‘‘(iii) section 732 of the Medicare Pre-
scription Drug, Improvement, and Mod-
ernization Act of 2003; 
‘‘(iv) section 104 of division B of the 
Tax Relief and Health Care Act of 2006; 
‘‘(v) section 104 of the Medicare, 
Medicaid, and SCHIP Extension Act of 
2007; 
‘‘(vi) section 136 of the Medicare Im-
provements for Patients and Providers Act 
of 2008; and 
‘‘(vii) section 105 of the Medicare and 
Medicaid Extenders Act of 2010.’’. 
Æ 
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