I
107TH CONGRESS
1ST SESSION
H. R. 1451
To amend title XVIII of the Social Security Act to provide for the fair
treatment of certain physician pathology services under the Medicare
Program.
IN THE HOUSE OF REPRESENTATIVES
APRIL 4, 2001
Mr. FOLEY (for himself, Mr. POMEROY, and Mr. TANNER) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means,
and in addition to the Committee on Energy and Commerce, for a period
to be subsequently determined by the Speaker, in each case for consider-
ation 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 the fair treatment of certain physician pathology
services under 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 ‘‘Physician Pathology
Services Fair Payment Act of 2001’’.
SEC. 2. TREATMENT OF CERTAIN PHYSICIAN PATHOLOGY
SERVICES.
(a) IN GENERAL.—Section 1848(i) of the Social Se-
curity Act (42 U.S.C. 1395w–4(i)) is amended by adding
at the end the following new paragraph:
‘‘(4) TREATMENT OF CERTAIN PHYSICIAN PA-
THOLOGY SERVICES.—
‘‘(A) IN GENERAL.—With respect to serv-
ices furnished on or after January 1, 2001, if
an independent laboratory furnishes the tech-
nical component of a physician pathology serv-
ice to a fee-for-service medicare beneficiary who
is an inpatient or outpatient of a covered hos-
pital, the Secretary shall treat such component
as a service for which payment shall be made
to the laboratory under this section and not as
an inpatient hospital service for which payment
is made to the hospital under section 1886(d)
or as a hospital outpatient service for which
payment is made to the hospital under section
1834(t).
‘‘(B) DEFINITIONS.—In this paragraph:
‘‘(i) COVERED HOSPITAL.—
‘‘(I) IN
GENERAL.—The term
‘covered hospital’ means, with respect
to an inpatient or outpatient, a hos-
pital that had an arrangement with
an independent laboratory that was in
effect as of July 22, 1999, under
which a laboratory furnished the tech-
nical component of physician pathol-
ogy services to fee-for-service medi-
care beneficiaries who were hospital
inpatients or outpatients, respectively,
and submitted claims for payment for
such component to a carrier with a
contract under section 1842 and not
to the hospital.
‘‘(II) CHANGE
IN
OWNERSHIP
DOES
NOT
AFFECT
DETERMINA-
TION.—A change in ownership with
respect to a hospital on or after the
date referred to in subclause (I) shall
not affect the determination of wheth-
er such hospital is a covered hospital
for purposes of such subclause.
‘‘(ii) 
FEE-FOR-SERVICE
MEDICARE
BENEFICIARY.—The term ‘fee-for-service
medicare beneficiary’ means an individual
who is entitled to benefits under part A, or
enrolled under this part, or both, but is not
enrolled in any of the following:
‘‘(I) A Medicare+Choice plan
under part C.
‘‘(II) A plan offered by an eligi-
ble organization under section 1876.
‘‘(III) A program of all-inclusive
care for the elderly (PACE) under
section 1894.
‘‘(IV) A social health mainte-
nance organization (SHMO) dem-
onstration project established under
section 4018(b) of the Omnibus
Budget Reconciliation Act of 1987
(Public Law 100–203).’’.
(b) CONFORMING AMENDMENT.—Section 542 of the
Medicare, Medicaid, and SCHIP Benefits Improvement
and Protection Act of 2000 (114 Stat. 2763A–550), as
enacted into law by section 1(a)(6) of Public Law 106–
554, is repealed.
(c) EFFECTIVE DATES.—The amendments made by
this section shall take effect as if included in the enact-
ment of the Medicare, Medicaid, and SCHIP Benefits Im-
provement and Protection Act of 2000 (appendix F, 114
Stat. 2763A–463), as enacted into law by section 1(a)(6)
of Public Law 106–554.
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