I 
117TH CONGRESS 
1ST SESSION H. R. 3517 
To amend title XVIII of the Social Security Act to improve access to, 
and utilization of, bone mass measurement benefits under part B of 
the Medicare program by establishing a minimum payment amount under 
such part for bone mass measurement. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 25, 2021 
Mr. LARSON of Connecticut (for himself, Mrs. WALORSKI, Ms. SA´NCHEZ, Mr. 
BURGESS, and Mrs. TRAHAN) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
access to, and utilization of, bone mass measurement 
benefits under part B of the Medicare program by estab-
lishing a minimum payment amount under such part 
for bone mass measurement. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Increasing Access to 
Osteoporosis Testing for Medicare Beneficiaries Act of 
2021’’. 
SEC. 2. FINDINGS. 
The Congress finds the following: 
(1) The total annual expense of providing care 
for osteoporotic fractures among Medicare bene-
ficiaries, including direct medical costs as well as in-
direct societal costs related to productivity losses 
and informal caregiving, has been estimated at $57 
billion in 2018, with an expected increase to over 
$95 billion in 2040. 
(2) Osteoporosis is a silent disease that often is 
not discovered until a fracture occurs. One out of 
two women and up to one of four men will suffer an 
osteoporotic fracture in their lifetimes. 
(3) Osteoporosis disproportionately impacts 
women, who account for 71 percent of osteoporotic 
fractures, and 75 percent of costs. 
(4) Most women are not aware of their personal 
risk factors for osteoporosis, the prevalence of, or 
the morbidity and mortality associated with the dis-
ease, despite the fact that broken bones due to 
osteoporosis lead to more hospitalizations and great-
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er health care costs than heart attack, stroke, or 
breast cancer in women age 55 and above. 
(5) A woman’s risk of hip fracture is equal to 
her combined risk of breast, uterine, and ovarian 
cancer. More women die in the United States in the 
year following a hip fracture than from breast can-
cer. 
(6) One out of four people who have an 
osteoporotic hip fracture will need long-term nursing 
home care. Half of those who experience osteoporotic 
hip fractures are unable to walk without assistance. 
(7) Nearly one in five Medicare patients die 
within one year of a new osteoporotic fracture. 
Beneficiaries with a hip fracture had the highest 
mortality where approximately 30 percent died with-
in 12 months of the fracture. 
(8) Bone density testing is more powerful in 
predicting fractures than cholesterol is in predicting 
myocardial infarction or blood pressure in predicting 
stroke. 
(9) Since 2007, Medicare has cut DXA reim-
bursement by over 72 percent. By 2019, the pay-
ment cuts caused a loss of 44 percent of DXA office 
providers resulting in declines in expected DXA test-
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ing, leaving 1.65 million women undiagnosed and 
untreated for osteoporosis. 
(10) A decade of steady decline in hip fractures 
stopped abruptly in 2013. As of 2019, there have 
been more than 71,775 additional hip fractures, 
costing almost $3 billion, leading to almost 16,000 
additional deaths than expected if the decline had 
continued. 
(11) An estimated 205,000 Medicare Fee For 
Service beneficiaries, or about 15 percent of those 
who had a new osteoporotic fracture, suffered one or 
more subsequent fractures within 12 months of the 
initial fracture. 
SEC. 3. INCREASING ACCESS TO OSTEOPOROSIS PREVEN-
TION AND TREATMENT. 
Section 1848(b) of the Social Security Act (42 U.S.C. 
1395w–4(b)) is amended— 
(1) in paragraph (4)(B)— 
(A) by striking ‘‘and the first 2 months of 
2012’’ and inserting ‘‘the first 2 months of 
2012, and 2022 and each subsequent year’’; 
and 
(B) by striking ‘‘paragraph (6)’’ and in-
serting ‘‘paragraphs (6) and (12)’’; and 
(2) by adding at the end the following: 
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‘‘(12) ESTABLISHING MINIMUM PAYMENT FOR 
OSTEOPOROSIS
TESTS.—For 
dual-energy 
x-ray 
absorptiometry services (identified by HCPCS codes 
77080 and 77082 and successor codes 77085 and 
77086 (and any succeeding codes)) furnished during 
2022 or a subsequent year, the Secretary shall es-
tablish a national minimum payment amount under 
this subsection— 
‘‘(A) for such services identified by 
HCPCS code 77080, equal to $98 (with na-
tional minimum payment amounts of $87.11 for 
the technical component and $10.89 for the 
professional component); 
‘‘(B) for such services identified by 
HCPCS code 77086, equal to $35 (with na-
tional minimum payment amounts of $27.18 for 
the technical component and $7.82 for the pro-
fessional component); and 
‘‘(C) for the bundled code for dual energy 
absorptiometry and vertebral fracture assess-
ment studies identified as HCPCS code 77085, 
equal to $133 (with national minimum payment 
amounts of $114.29 for the technical compo-
nent and $18.71 for the professional compo-
nent). 
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Such minimum payment amounts shall be adjusted 
by the geographical adjustment factor established 
under subsection (e)(2) for the services for the re-
spective year.’’. 
Æ 
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