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professional component of a diagnostic im-
aging service that is furnished by a physi-
cian. 
‘‘(ii) 
DIAGNOSTIC
IMAGING
SERV-
ICES.—For purposes of clause (i) and sub-
section (m), the term ‘diagnostic imaging 
services’ means all imaging modalities, in-
cluding diagnostic magnetic resonance im-
aging 
(‘MRI’), 
computed 
tomography 
(‘CT’), 
positron 
emission 
tomography 
(‘PET’), nuclear medicine procedures, x- 
rays, sonograms, ultrasounds, echocardio-
grams, and such emerging diagnostic im-
aging technologies as specified by the Sec-
retary.’’. 
(B) EFFECTIVE DATE.— 
(i) IN
GENERAL.—Subject to clause 
(ii), the amendments made by subpara-
graph (A) shall apply to diagnostic imag-
ing services furnished on or after January 
1, 2010. 
(ii) EXTENSION
FOR
ULTRASOUND 
SERVICES.—The amendments made by 
subparagraph (A) shall apply to diagnostic 
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imaging services that are ultrasound serv-
ices on or after January 1, 2012. 
(2) CERTIFICATION OF FACILITIES THAT FUR-
NISH
DIAGNOSTIC
IMAGING
SERVICES.—Section 
1848 of the Social Security Act (42 U.S.C. 1395w– 
4) is amended by adding at the end the following 
new subsection: 
‘‘(m) CERTIFICATION OF FACILITIES THAT FURNISH 
DIAGNOSTIC IMAGING SERVICES.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(b)(4)(C)(i), except as provided under paragraphs 
(2) through (8), the provisions of section 354 of the 
Public Health Service Act (as in effect as of June 
1, 2007), relating to the certification of mammog-
raphy facilities, shall apply, with respect to the pro-
vision of diagnostic imaging services (as defined in 
subsection (b)(4)(C)(ii)) and to a diagnostic imaging 
services facility defined in paragraph (8) (and to the 
process of accrediting such facilities) in the same 
manner that such provisions apply, with respect to 
the provision of mammograms and to a facility de-
fined in subsection (a)(3) of such section (and to the 
process of accrediting such mammography facilities). 
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‘‘(2) TERMINOLOGY
AND
REFERENCES.—For 
purposes of applying section 354 of the Public 
Health Service Act under paragraph (1)— 
‘‘(A) any reference to ‘mammography’, or 
‘breast imaging’ is deemed a reference to ‘diag-
nostic imaging services (as defined in section 
1848(b)(4)(C)(ii) of the Social Security Act)’; 
‘‘(B) any reference to a mammogram or 
film is deemed a reference to an image, as de-
fined in paragraph (8); 
‘‘(C) any reference to ‘mammography facil-
ity’ or to a ‘facility’ under such section 354 is 
deemed a reference to a diagnostic imaging 
services facility, as defined in paragraph (8); 
‘‘(D) any reference to radiological equip-
ment used to image the breast is deemed a ref-
erence to medical imaging equipment used to 
provide diagnostic imaging services; 
‘‘(E) any reference to radiological proce-
dures or radiological is deemed a reference to 
medical imaging services, as defined in para-
graph (8) or medical imaging, respectively; 
‘‘(F) any reference to an inspection (as de-
fined in subsection (a)(4) of such section) or in-
spector is deemed a reference to an audit (as 
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HR 3162 PCS
defined in paragraph (8)) or auditor, respec-
tively; 
‘‘(G) any reference to a medical physicist 
(as described in subsection (f)(1)(E) of such 
section) is deemed to include a reference to a 
magnetic resonance scientist or the appropriate 
qualified expert as determined by the accred-
iting body; 
‘‘(H) in applying subsection (d)(1)(A)(i) of 
such section, the reference to ‘type of each x- 
ray machine, image receptor, and processor’ is 
deemed a reference to ‘type of imaging equip-
ment’; 
‘‘(I) in applying subsection (d)(1)(B) of 
such section, the reference that ‘the person or 
agent submits to the Secretary’ is deemed a ref-
erence that ‘the person or agent submits to the 
Secretary, through the appropriate accredita-
tion body’; 
‘‘(J) in applying subsection (d)(1)(B)(i) of 
such section, the reference to standards estab-
lished by the Secretary is deemed a reference to 
standards established by an accreditation body 
and approved by the Secretary; 
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‘‘(K) in applying subsection (e) of such 
section, relating to an accreditation body— 
‘‘(i) in paragraph (1)(A), the ref-
erence to ‘may’ is deemed a reference to 
‘shall’; 
‘‘(ii) in paragraph (1)(B)(i)(II), the 
reference to ‘a random sample of clinical 
images from such facilities’ is deemed a 
reference to ‘a statistically significant ran-
dom sample of clinical images from a sta-
tistically significant random sample of fa-
cilities’; 
‘‘(iii) in paragraph (3)(A) of such sec-
tion— 
‘‘(I) the reference to ‘paragraph 
(1)(B)’ in such subsection is deemed 
to be a reference to ‘paragraph (1)(B) 
and subsection (f)’; and 
‘‘(II) the reference to the ‘Sec-
retary’ is deemed a reference to ‘an 
accreditation body, with the approval 
of the Secretary’; and 
‘‘(iv) in paragraph (6)(B), the ref-
erence to the Committee on Labor and 
Human Resources of the Senate is deemed 
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HR 3162 PCS
to be the Committee on Finance of the 
Senate and the reference to the Committee 
on Energy and Commerce of the House of 
Representatives is deemed to include a ref-
erence to the Committee on Ways and 
Means of the House of Representatives; 
‘‘(L) in applying subsection (f), relating to 
quality standards— 
‘‘(i) each reference to standards estab-
lished by the Secretary is deemed a ref-
erence to standards established by an ac-
creditation body involved and approved by 
the Secretary under subsection (d)(1)(B)(i) 
of such section; 
‘‘(ii) in paragraph (1)(A), the ref-
erence to ‘radiation dose’ is deemed a ref-
erence to ‘radiation dose, as appropriate’; 
‘‘(iii) in paragraph (1)(B), the ref-
erence to ‘radiological standards’ is deemed 
a reference to ‘medical imaging standards, 
as appropriate’; 
‘‘(iv) in paragraphs (1)(D)(ii) and 
(1)(E)(iii), the reference to ‘the Secretary’ 
is deemed a reference to ‘an accreditation 
body with the approval of the Secretary’; 
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HR 3162 PCS
‘‘(v) in each of subclauses (III) and 
(IV) of paragraph (1)(G)(ii), each ref-
erence to ‘patient’ is deemed a reference to 
‘patient, if requested by the patient’; and 
‘‘(M) in applying subsection (g), relating to 
inspections— 
‘‘(i) each reference to the ‘Secretary 
or State or local agency acting on behalf of 
the Secretary’ is deemed to include a ref-
erence to an accreditation body involved; 
‘‘(ii) in the first sentence of para-
graph (1)(F), the reference to ‘annual in-
spections required under this paragraph’ is 
deemed a reference to ‘the audits carried 
out in facilities at least every three years 
from the date of initial accreditation under 
this paragraph’; and 
‘‘(iii) in the second sentence of para-
graph (1)(F), the reference to ‘inspections 
carried out under this paragraph’ is 
deemed a reference to ‘audits conducted 
under this paragraph during the previous 
year’. 
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‘‘(3) DATES AND PERIODS.—For purposes of 
paragraph (1), in applying section 354 of the Public 
Health Service Act, the following applies: 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B)— 
‘‘(i) any reference to ‘October 1, 
1994’ shall be deemed a reference to ‘Jan-
uary 1, 2010’; 
‘‘(ii) the reference to ‘the date of the 
enactment of this section’ in each of sub-
sections (e)(1)(D) and (f)(1)(E)(iii) is 
deemed to be a reference to ‘the date of 
the enactment of the Children’s Health 
and Medicare Protection Act of 2007’; 
‘‘(iii) the reference to ‘annually’ in 
subsection (g)(1)(E) is deemed a reference 
to ‘every three years’; 
‘‘(iv) the reference to ‘October 1, 
1996’ in subsection (l) is deemed to be a 
reference to ‘January 1, 2011’; 
‘‘(v) the reference to ‘October 1, 
1999’ in subsection (n)(3)(H) is deemed to 
be a reference to ‘January 1, 2012’; and 
‘‘(vi) the reference to ‘October 1, 
1993’ in the matter following paragraph 
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HR 3162 PCS
(3)(J) of subsection (n) is deemed to be a 
reference ‘January 1, 2010’. 
‘‘(B) ULTRASOUND
SERVICES.—With re-
spect to diagnostic imaging services that are 
ultrasounds— 
‘‘(i) any reference to ‘October 1, 
1994’ shall be deemed a reference to ‘Jan-
uary 1, 2012’; 
‘‘(ii) the reference to ‘the date of the 
enactment of this section’ in subsection 
(f)(1)(E)(iii) is deemed to be a reference to 
‘7 years after the date of the enactment of 
the Children’s Health and Medicare Pro-
tection Act of 2007’; 
‘‘(iii) the reference to ‘October 1, 
1996’ in subsection (l) is deemed to be a 
reference to ‘January 1, 2013’; 
‘‘(4) PROVISIONS NOT APPLICABLE.—For pur-
poses of paragraph (1), in applying section 354 of 
the Public Health Service Act, the following provi-
sion shall not apply: 
‘‘(A) Subsections (e) and (f) of such sec-
tion, in so far as the respective subsection im-
poses any requirement for a physician to be cer-
tified, accredited, or otherwise meet require-
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HR 3162 PCS
ments, with respect to the provision of any di-
agnostic imaging services, as a condition of pay-
ment under subsection (b)(4)(C)(i), with re-
spect to the professional or technical compo-
nent, for such service. 
‘‘(B) Subsection (e)(1)(B)(v). 
‘‘(C) Subsection (f)(1)(H) of such section, 
relating to standards for special techniques for 
mammograms of patients with breast implants. 
‘‘(D) Subsection (g)(6) of such section, re-
lating to an inspection demonstration program. 
‘‘(E) Subsection (n) of such section, relat-
ing to the national advisory committee. 
‘‘(F) Subsection (p) of such section, relat-
ing to breast cancer screening surveillance re-
search grants. 
‘‘(G) Paragraphs (1)(B) and (2) of sub-
section (r) of such section, related to funding. 
‘‘(5) ACCREDITATION
BODIES.—For purposes 
of paragraph (1), in applying section 354(e)(1) of 
the Public Health Service, the following shall apply: 
‘‘(A) APPROVAL OF TWO ACCREDITATION 
BODIES FOR EACH TREATMENT MODALITY.—In 
the case that there is more than one accredita-
tion body for a treatment modality that quali-
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HR 3162 PCS
fies for approval under this subsection, the Sec-
retary shall approve at least two accreditation 
bodies for such treatment modality. 
‘‘(B) ADDITIONAL
ACCREDITATION
BODY 
STANDARDS.—In addition to the standards de-
scribed in subparagraph (B) of such section for 
accreditation bodies, the Secretary shall estab-
lish standards that require— 
‘‘(i) the timely integration of new 
technology by accreditation bodies for pur-
poses of accrediting facilities under this 
subsection; and 
‘‘(ii) the accreditation body involved to 
evaluate the annual medical physicist sur-
vey (or annual medical survey of another 
appropriate qualified expert chosen by the 
accreditation body) of a facility upon on-
site review of such facility. 
‘‘(6) ADDITIONAL QUALITY STANDARDS.—For 
purposes of paragraph (1), in applying subsection 
(f)(1) of section 354 of the Public Health Service— 
‘‘(A) the quality standards under such sub-
section shall, with respect to a facility include— 
‘‘(i) standards for qualifications of 
medical personnel who are not physicians 
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and who perform diagnostic imaging serv-
ices at the facility that require such per-
sonnel to ensure that individuals, prior to 
performing medical imaging, demonstrate 
compliance with the standards established 
under subsection (a) through successful 
completion of certification by a nationally 
recognized professional organization, licen-
sure, completion of an examination, perti-
nent 
coursework 
or 
degree 
program, 
verified pertinent experience, or through 
other ways determined appropriate by an 
accreditation body (with the approval of 
the Secretary, or through some combina-
tion thereof); 
‘‘(ii) standards requiring the facility 
to maintain records of the credentials of 
physicians and other medical personnel de-
scribed in clause (i); 
‘‘(iii) standards for qualifications and 
responsibilities of medical directors and 
other personnel with supervising roles at 
the facility; 
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‘‘(iv) standards that require the facil-
ity has procedures to ensure the safety of 
patients of the facility; and 
‘‘(v) standards for the establishment 
of a quality control program at the facility 
to be implemented as described in subpara-
graph (E) of such subsection; 
‘‘(B) the quality standards described in 
subparagraph (B) of such subsection shall be 
deemed to include standards that require the 
establishment and maintenance of a quality as-
surance and quality control program at each fa-
cility that is adequate and appropriate to en-
sure the reliability, clarity, and accuracy of the 
technical quality of diagnostic images produced 
at such facilities; and 
‘‘(C) the quality standard described in sub-
paragraph (C) of such subsection, relating to a 
requirement for personnel who perform speci-
fied services, shall include in such requirement 
that such personnel must meet continuing med-
ical education standards as specified by an ac-
creditation body (with the approval of the Sec-
retary) and update such standards at least once 
every three years. 
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