I 
111TH CONGRESS 
1ST SESSION H. R. 1894 
To amend title XVIII of the Social Security Act to improve access to, 
and increase utilization of, bone mass measurement benefits under the 
Medicare part B program. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 2, 2009 
Ms. BERKLEY (for herself, Mr. BURGESS, Mr. PAYNE, Mr. GRIJALVA, Mr. 
MCGOVERN, Mrs. CAPPS, Ms. SCHAKOWSKY, Mr. LEWIS of Georgia, Mr. 
OLVER, Ms. BALDWIN, Mr. SESTAK, Mr. HINOJOSA, Mr. CULBERSON, 
Mr. BOSWELL, Mr. GENE GREEN of Texas, Ms. KILPATRICK of Michi-
gan, Mr. PAUL, Mrs. LOWEY, Mr. COURTNEY, Ms. SUTTON, Ms. 
WASSERMAN SCHULTZ, Mrs. CHRISTENSEN, Ms. JACKSON-LEE of Texas, 
Ms. SCHWARTZ, Mr. SESSIONS, Mr. THOMPSON of California, Ms. KIL-
ROY, Ms. HIRONO, Mr. MCDERMOTT, Ms. CASTOR of Florida, Mr. 
FALEOMAVAEGA, Mrs. DAVIS of California, Mr. ENGEL, Mr. WEXLER, 
Mr. TANNER, Mr. FARR, Mr. SHERMAN, Ms. WATSON, Ms. TITUS, Ms. 
MOORE of Wisconsin, Ms. LINDA T. SA´NCHEZ of California, Ms. 
KOSMAS, Mr. KENNEDY, Mr. GEORGE MILLER of California, Ms. SPEIER, 
Ms. TSONGAS, Ms. DEGETTE, Mrs. NAPOLITANO, Mr. CARNAHAN, Ms. 
ROYBAL-ALLARD, Mr. KAGEN, Ms. HARMAN, Mr. SERRANO, Ms. MAR-
KEY of Colorado, Mr. SCOTT of Virginia, Ms. SHEA-PORTER, Mrs. 
MALONEY, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. MEEKS of New 
York, Ms. WOOLSEY, Ms. LEE of California, Ms. CLARKE, Ms. CORRINE 
BROWN of Florida, Ms. EDWARDS of Maryland, and Mr. PIERLUISI) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
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access to, and increase utilization of, bone mass measure-
ment benefits under the Medicare part B 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 ‘‘Medicare Fracture 
Prevention and Osteoporosis Testing Act of 2009’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Since 1997, Congress has recognized the 
importance of osteoporosis prevention by standard-
izing reimbursement under the Medicare program 
for bone mass measurement. 
(2) One decade later, osteoporosis remains 
underdiagnosed and untreated despite numerous 
Federal initiatives, including recommendations of the 
United States Preventive Services Task Force, the 
2004 United States Surgeon General’s Report on 
Bone Health and Osteoporosis, and inclusion of bone 
mass measurement in the Welcome to Medicare 
exam. 
(3) Even though osteoporosis is a highly man-
ageable disease, many patients lack access to early 
diagnosis that can prevent debilitating fractures, 
morbidity, and loss of mobility. 
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(4) Although Caucasians are most likely to sus-
tain osteoporosis fractures, the cost of fractures 
among the nonwhite population is projected to in-
crease by as much as 180 percent over the next 20 
years. 
(5) Black women are more likely than White 
women to die following a hip fracture. 
(6) Osteoporosis is a critical women’s health 
issue. Women account for 71 percent of fractures 
and 75 percent of osteoporosis-associated costs. 
(7) The World Health Organization, the Cen-
ters for Medicare & Medicaid Services, and other 
medical experts concur that the most widely accept-
ed method of measuring bone mass to predict frac-
ture risk is dual-energy x-ray absorptiometry (in this 
Act referred to as ‘‘DXA’’). Vertebral fracture as-
sessment (in this Act referred to as ‘‘VFA’’) is an-
other test used to identify patients at high risk for 
future fracture. 
(8) DXA is a cost-effective preventive test with 
proven results in real world settings. DXA testing 
increases the number of people diagnosed with 
osteoporosis and treated so that hip fractures and 
related costs are dramatically reduced. 
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(9) Unlike other imaging procedures DXA re-
mains severely underutilized, with only one in four 
women eligible for the Medicare program using the 
benefit that provides for bone mass measurement 
every two years. 
(10) Underutilization of bone mass measure-
ment will strain the Medicare budget because— 
(A) 55 percent of the people age 50 and 
older in 2002 had osteoporosis or low bone 
mass; 
(B) more than 61,000,000 people in the 
United States are projected to have osteoporosis 
or low bone mass in 2020, as compared to 
43,000,000 in 2002; 
(C) osteoporosis fractures are projected to 
increase by almost 50 percent over the next 2 
decades with at least 3,000,000 fractures ex-
pected to occur annually by 2025; 
(D) the population aged 65 and older rep-
resents 89 percent of fracture costs; and 
(E) the economic burden of osteoporosis 
fractures are projected to increase by 50 per-
cent over the next 2 decades, reaching 
$25,300,000,000 in 2025. 
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