I
104TH CONGRESS
1ST SESSION
H. R. 922
To amend title XVIII of the Social Security Act to provide for coverage
of colorectal screening under part B of the medicare program.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 13, 1995
Mr. CARDIN (for himself, Mr. COYNE, Mr. YATES, Mr. GENE GREEN of
Texas, Mr. MCCRERY, Mrs. MINK of Hawaii, Mrs. MORELLA, Mr. HORN,
Mr. FROST, Mr. MCDERMOTT, Mr. BLUTE, Mr. FOGLIETTA, Mr. DEL-
LUMS, Mr. BONIOR, Mr. BREWSTER, MR. BEILENSON, Ms. PELOSI, and
Mr. FORD) introduced the following bill; which was referred to the Com-
mittee on 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 provide
for coverage of colorectal screening under part B of
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 ‘‘Colon Cancer Screen-
ing and Prevention Act’’.
SEC. 2. MEDICARE COVERAGE OF COLORECTAL SCREEN-
ING.
(a) IN GENERAL.—Section 1834 of the Social Secu-
rity Act (42 U.S.C. 1395m) is amended by inserting after
subsection (c) the following new subsection:
‘‘(d) FREQUENCY
AND
PAYMENT
LIMITS
FOR
SCREENING FECAL-OCCULT BLOOD TESTS, SCREENING
FLEXIBLE
SIGMOIDOSCOPIES, 
AND
SCREENING
COLONOSCOPY.—
‘‘(1) 
SCREENING
FECAL-OCCULT
BLOOD
TESTS.—
‘‘(A) PAYMENT LIMIT.—In establishing fee
schedules under section 1833(h) with respect to
screening fecal-occult blood tests provided for
the purpose of early detection of colon cancer,
except as provided by the Secretary under para-
graph (3)(A), the payment amount established
for tests performed—
‘‘(i) in 1996 shall not exceed $5; and
‘‘(ii) in a subsequent year, shall not
exceed the limit on the payment amount
established under this subsection for such
tests for the preceding year, adjusted by
the applicable adjustment under section
1833(h) for tests performed in such year.
‘‘(B) FREQUENCY LIMIT.—Subject to revi-
sion by the Secretary under paragraph (3)(B),
no payment may be made under this part for
a screening fecal-occult blood test provided to
an individual for the purpose of early detection
of colon cancer—
‘‘(i) if the individual is under 50 years
of age; or
‘‘(ii) if the test is performed within
the 11 months after a previous screening
fecal-occult blood test.
‘‘(2) 
SCREENING
FLEXIBLE
SIGMOID-
OSCOPIES.—
‘‘(A) PAYMENT AMOUNT.—The Secretary
shall establish a payment amount under section
1848 
with 
respect 
to 
screening 
flexible
sigmoidoscopies provided for the purpose of
early detection of colon cancer that is consistent
with payment amounts under such section for
similar or related services, except that such
payment amount shall be established without
regard to subsection (a)(2)(A) of such section.
‘‘(B) FREQUENCY LIMIT.—Subject to revi-
sion by the Secretary under paragraph (4)(B),
no payment may be made under this part for
a screening flexible sigmoidoscopy provided to
an individual for the purpose of early detection
of colon cancer—
‘‘(i) if the individual is under 50 years
of age; or
‘‘(ii) if the procedure is performed
within the 47 months after a previous
screening flexible sigmoidoscopy.
‘‘(3) SCREENING COLONOSCOPY FOR INDIVID-
UALS AT HIGH RISK FOR COLORECTAL CANCER.—
‘‘(A) PAYMENT AMOUNT.—The Secretary
shall establish a payment amount under section
1848 with respect to screening colonoscopy for
individuals at high risk for colorectal cancer (as
defined in subparagraph (C)) provided for the
purpose of early detection of colon cancer that
is consistent with payment amounts under such
section for similar or related services, except
that such payment amount shall be established
without regard to subsection (a)(2)(A) of such
section.
‘‘(B) FREQUENCY LIMIT.—Subject to revi-
sion by the Secretary under paragraph (4)(B),
no payment may be made under this part for
a screening colonoscopy for individuals at high