I 
117TH CONGRESS 
1ST SESSION H. R. 4612 
To amend title XVIII of the Social Security Act to protect coverage for 
screening mammography, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 21, 2021 
Ms. WASSERMAN SCHULTZ (for herself and Mr. UPTON) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committees on Ways and Means, and Vet-
erans’ Affairs, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to protect 
coverage for screening mammography, and for other pur-
poses. 
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 ‘‘Protecting Access to 
Lifesaving Screenings Act of 2021’’ or the ‘‘PALS Act’’. 
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SEC. 2. PROTECTING COVERAGE FOR SCREENING MAM-
MOGRAPHY. 
(a) IN GENERAL.—Effective during the period begin-
ning on the date of the enactment of this Act and ending 
January 1, 2028, any provision of law that refers (includ-
ing through cross-reference to another provision of law) 
to the current recommendations of the United States Pre-
ventive Services Task Force with respect to breast cancer 
screening mammography shall be administered as if— 
(1) such reference to such current recommenda-
tions were a reference to the recommendations of 
such Task Force with respect to breast cancer 
screening mammography last issued before 2009; 
and 
(2) such recommendations last issued before 
2009 applied to any screening mammography modal-
ity under section 1861(jj) of the Social Security Act 
(42 U.S.C. 1395x(jj)). 
(b) CONTINUING MEDICARE COVERAGE WITHOUT 
COINSURANCE.—Section 1833(a)(1)(Y) of the Social Se-
curity Act (42 U.S.C. 1395l(a)(1)(Y)) is amended by in-
serting after ‘‘in the case of such services described in sub-
paragraph (A)’’ the following: ‘‘(other than screening 
mammography)’’. 
(c) MAINTAINING FREQUENCY OF MEDICARE COV-
ERAGE.—Section 1834(c)(2)(B)(ii) of the Social Security 
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Act (42 U.S.C. 1395m(c)(2)(B)(ii)) is amended by insert-
ing before the period at the end the following: ‘‘, except 
that in the case of a woman over 39 years of age, such 
revision may not decrease such frequency’’. 
(d) CLARIFYING THE DEFINITION OF SCREENING 
MAMMOGRAPHY.—Section 1861(jj) of the Social Security 
Act (42 U.S.C. 1395x(jj)) is amended by inserting ‘‘, in-
cluding any digital modality (such as screening breast 
tomosynthesis) of such a procedure,’’ after ‘‘radiologic 
procedure’’. 
(e) 
APPLICATION
TO
SERVICES
FURNISHED 
THROUGH DEPARTMENT OF VETERANS AFFAIRS.—Sec-
tion 7322(b) of title 38, United States Code, is amended 
to read as follows: 
‘‘(b) The policy developed under subsection (a), and 
any other policy of the Department of Veterans Affairs 
relating to mammography screening, shall— 
‘‘(1) specify standards of mammography screen-
ing that ensure that the frequency of such 
screenings is not less than the frequency of such 
screenings provided pursuant to section 2(a) of the 
Protecting Access to Lifesaving Screenings Act of 
2021; 
‘‘(2) provide recommendations, consistent with 
paragraph (1), with respect to screening, and the 
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frequency of screening, for veterans, without regard 
to age, who have clinical symptoms, risk factors, or 
family history of breast cancer; and 
‘‘(3) provide for clinician discretion in indi-
vidual cases.’’. 
Æ 
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