I 
108TH CONGRESS 
1ST SESSION 
H. R. 817
To amend title XVIII of the Social Security Act to provide for enhanced 
reimbursement under the Medicare Program for screening and diagnostic 
mammography services, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 13, 2003
Mr. KING of New York (for himself, Mr. HOBSON, Ms. SLAUGHTER, Mr. 
FOSSELLA, Ms. ROS-LEHTINEN, Mr. COSTELLO, Mr. TOWNS, Mr. 
HONDA, Mr. SOUDER, Mr. WALSH, Mr. TIBERI, Mr. BOEHLERT, Mr. 
LATOURETTE, Mr. NEAL of Massachusetts, Mr. GORDON, Mr. OBER-
STAR, Mr. REYES, Ms. WOOLSEY, Mr. HINCHEY, Mr. STRICKLAND, Mr. 
MCHUGH, Mr. FROST, Mr. SWEENEY, Ms. CORRINE BROWN of Florida, 
Ms. NORTON, Mr. FORBES, Ms. BORDALLO, Mr. MCINTYRE, Mr. 
RODRIGUEZ, Mrs. CAPPS, Mr. FORD, Mr. MCNULTY, Mr. KILDEE, Mr. 
MEEHAN, Mr. DEUTSCH, Ms. MILLENDER-MCDONALD, Mr. BISHOP of 
New York, Mrs. MCCARTHY of New York, Mrs. CHRISTENSEN, Mr. 
TERRY, Mr. PASCRELL, Mr. SIMMONS, Mr. ABERCROMBIE, Mr. TAYLOR 
of Mississippi, Mr. GUTIERREZ, Mr. LOBIONDO, Mr. PAYNE, Mr. RAN-
GEL, Mr. DAVIS of Illinois, Mr. DELAHUNT, Mr. SERRANO, Mrs. JO ANN 
DAVIS of Virginia, Mr. ACKERMAN, Mrs. KELLY, Ms. LINDA T. SA´NCHEZ 
of California, Mr. NADLER, Mr. OWENS, Mr. ETHERIDGE, Mr. FARR, and 
Mr. GONZALEZ) 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 committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for enhanced reimbursement under the Medicare Pro-
gram for screening and diagnostic mammography serv-
ices, and for other purposes.
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 ‘‘Assure Access to Mam-
mography Act of 2003’’. 
SEC. 2. ENHANCED REIMBURSEMENT UNDER THE MEDI-
CARE PROGRAM FOR SCREENING AND DIAG-
NOSTIC 
MAMMOGRAPHY 
SERVICES 
FUR-
NISHED IN 2003. 
(a) PAYMENTS TO FACILITIES FOR SCREENING AND 
DIAGNOSTIC MAMMOGRAPHY.—
(1) IN GENERAL.—Notwithstanding any other 
provision of law, with respect to payment for a 
screening or diagnostic mammography furnished to 
a medicare beneficiary, the amount of payment made 
to a hospital-based facility (defined in paragraph 
(4)) in which such screening or diagnostic mammog-
raphy is performed during the applicable period de-
scribed in paragraph (3) is equal to 200 percent of 
the amount of payment that would otherwise apply 
under the fee schedule established under section 
1848 of the Social Security Act (42 U.S.C. 1395w–
4) with respect to the technical component of such 
screening or diagnostic mammography.
(2) TEMPORARY PAYMENT RULE.—With respect 
to payments to a hospital-based facility for screening 
or diagnostic mammography described in paragraph 
(1) during the applicable period, payment shall be 
made to the facility for such mammography pursu-
ant to this subsection and shall not be made under 
section 1833(t) of such Act (42 U.S.C. 1395l(t)). 
(3) APPLICABLE PERIOD.—The applicable pe-
riod referred to in paragraph (1) is the period begin-
ning on the date of the enactment of this Act and 
ending on the date the Secretary establishes and im-
plements an appropriate facility payment rate under 
the prospective payment system for covered out-
patient services under such section 1833(t) for a 
screening or diagnostic mammography furnished to 
a medicare beneficiary, but in no case less than the 
amount payment provided for in paragraph (1). 
(4) HOSPITAL-BASED FACILITY DEFINED.—In 
this subsection, the term ‘‘hospital-based facility’’ 
means a facility for which payment is made for a di-
agnostic or screening mammography under such sec-
tion 1833(t) but for this subsection. 
(b) NOT COUNTING CERTAIN RADIOLOGY RESI-
DENTS AGAINST GRADUATE MEDICAL EDUCATION LIMI-
TATIONS.—
(1) IN GENERAL.—For cost reporting periods 
beginning on or after October 1, 2003, and before 
October 1, 2008, in applying the limitations regard-
ing the total number of full-time equivalent residents 
in the field of allopathic or osteopathic medicine 
under subsections (d)(5)(B)(v) and (h)(4)(F) of sec-
tion 1886 of the Social Security Act (42 U.S.C. 
1395ww) for a hospital, the Secretary of Health and 
Human Services shall not take into account 1 addi-
tional resident in the field of radiology per post-
graduate year during each such cost reporting period 
to the extent the hospital increases the number of 
radiology residents above the number of such resi-
dents for the hospital’s most recent cost reporting 
period ending before October 1, 2003. 
(2) TREATMENT
FOR
ENTIRE
PERIOD
OF 
TRAINING PROGRAM.—The provisions of paragraph 
(1) shall apply for each year of the full-time equiva-
lent resident’s approved medical residency training 
program in the field of radiology not taken into ac-
count by reason of paragraph (1). 
(c) CONSTRUCTION.—Nothing in this section shall be 
construed as affecting the provisions of section 104(d) of 
the Medicare, Medicaid, and SCHIP Benefits Improve-
ment and Protection Act of 2000 (as enacted into law by
(2) RECOMMENDATIONS.—The report shall in-
clude such recommendations regarding the appro-
priateness of adjusting the relative value units for 
physicians’ services or the prospective payment 
amounts for inpatient hospital services or covered 
skilled nursing facility services that are gender-spe-
cific, as the Institute determines appropriate. 
(3) TRANSMISSION
TO
CONGRESS.—The Sec-
retary shall promptly transmit a copy of such report 
to Congress. 
SEC. 4. MEDPAC STUDY AND REPORT ON MEDICARE REIM-
BURSEMENT FOR SCREENING SERVICES. 
(a) STUDY.—The Medicare Payment Advisory Com-
mission shall conduct a study of the relative value units 
established by the Secretary of Health and Human Serv-
ices under the medicare physician fee schedule under sec-
tion 1848 of the Social Security Act (42 U.S.C. 1395w–
4) for screening services that are reimbursed under such 
fee schedule. 
(b) REPORT.—Not later than March 1, 2004, the 
Commission shall submit to Congress a report on the 
study conducted under subsection (a), together with such 
recommendations regarding the appropriateness of adjust-
ing the relative value units for screening services that are
reimbursed under the physician fee schedule as the Com-
mission determines appropriate.
Æ