I 
113TH CONGRESS 
1ST SESSION H. R. 1320 
To amend title XVIII of the Social Security Act to improve coverage for 
colorectal screening tests under Medicare, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 21, 2013 
Mr. NEAL 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 juris-
diction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
coverage for colorectal screening tests under Medicare, 
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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Supporting Colorectal Examination and Education Now 
Act of 2013’’ or the ‘‘SCREEN Act of 2013’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
VerDate Mar 15 2010 
00:24 Mar 28, 2013
Jkt 029200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H1320.IH
H1320
tjames on DSK6SPTVN1PROD with BILLS
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Temporary increase in payment rate for certain cancer screening tests. 
Sec. 4. Waiving Medicare cost-sharing for colorectal cancer screening with 
therapeutic effect. 
Sec. 5. Medicare coverage for an office visit or consultation prior to a qualifying 
screening colonoscopy. 
Sec. 6. Budget neutrality. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Colon cancer is the third most common 
cause of cancer-related deaths and the second most 
common cancer for both men and women. 
(2) According to the American Cancer Society, 
over 50,000 people will die this year from colon can-
cer. 
(3) Colorectal cancer is highly treatable with 
appropriate screening. According to the American 
Cancer Society (2010 Facts & Figures), the 5-year 
survival rate is 90 percent for those individuals who 
are diagnosed at an early stage of the cancer. How-
ever, less than 40 percent of colon cancer cases are 
diagnosed at an early stage. 
(4) The Centers for Disease Control and Pre-
vention recently estimated that approximately 2,000 
deaths could be avoided if colonoscopy screening 
rates rose by just 10 percent. 
(5) 
Colonoscopies 
allow 
for 
simultaneous 
colorectal cancer screenings and detection and the 
VerDate Mar 15 2010 
00:24 Mar 28, 2013
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H1320.IH
H1320
tjames on DSK6SPTVN1PROD with BILLS
removal of precancerous polyps, thus preventing can-
cer from developing. 
(6) The U.S. Preventive Services Task Force 
provides an ‘‘A’’ rating for colorectal cancer 
screenings. 
(7) The Centers for Disease Control and Pre-
vention’s colorectal cancer control program has set a 
target of screening 80 percent of eligible adults in 
certain States by 2014. The American Cancer Soci-
ety and other patient advocacy groups have a target 
rate of 75 percent. 
(8) Only between 52 and 58 percent of Medi-
care beneficiaries have had any colorectal cancer 
screening test, despite Medicare coverage for such 
tests. 
(9) Only 49.3 percent of Medicare beneficiaries 
who are 50 to 80 years old receive colorectal cancer 
screenings within recommended intervals. 
(10) The Centers for Medicare & Medicaid 
Services notes that there is ‘‘clearly an opportunity 
to improve colorectal cancer screening rates in the 
Medicare population’’. 
(11) A January 2011 study by the Colon Can-
cer Alliance concludes that most Americans over the 
age of 50— 
VerDate Mar 15 2010 
00:24 Mar 28, 2013
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1320.IH
H1320
tjames on DSK6SPTVN1PROD with BILLS
(A) wish a health care provider was able to 
sit down with them to discuss a colonoscopy be-
fore undergoing the test; and 
(B) forgo a colonoscopy due to fear of the 
procedure. 
(12) In February 2010, the National Institutes 
of Health hosted a conference on colorectal cancer 
screening and cited patient awareness and fears as 
barriers to increasing colorectal cancer screening 
rates. 
(13) According to the Medicare Payment Advi-
sory Commission, colonoscopy is one of the most 
common procedures performed in the ambulatory 
surgical centers (ASCs) and ‘‘the decline in payment 
rate for the highest volume procedures is especially 
a strong concern for ASCs that focus on gastro-
enterology’’. 
(14) An Institute of Medicine study on 
colorectal cancer screening cited the inadequate re-
imbursement for preventive care services as one of 
the constraints limiting colorectal cancer screening 
rates. 
(15) Colorectal cancer screening by colonoscopy 
has been demonstrated to reduce Medicare costs 
over the long-term. 
VerDate Mar 15 2010 
00:24 Mar 28, 2013
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H1320.IH
H1320
tjames on DSK6SPTVN1PROD with BILLS
SEC. 3. TEMPORARY INCREASE IN PAYMENT RATE FOR 
CERTAIN CANCER SCREENING TESTS. 
(a) IN GENERAL.—With respect to a qualifying can-
cer screening test furnished during the 5-year period be-
ginning on January 1, 2014, by a qualifying provider, the 
amount otherwise payable under section 1833 or section 
1848 of the Social Security Act (42 U.S.C. 1395l, 1395w– 
4) to such provider for such test shall be increased by 10 
percent. 
(b) QUALIFYING CANCER SCREENING TEST.— 
(1) IN GENERAL.—For purposes of this section, 
subject to paragraph (2), the term ‘‘qualifying can-
cer screening test’’ means, with respect to a Medi-
care beneficiary, a cancer screening test that has in 
effect with respect to such beneficiary a rating of ‘A’ 
in the current recommendations of the United States 
Preventive Services Task Force. 
(2) TERMINATION
WHEN
HIGH
UTILIZATION 
RATE REACHED.—If the Secretary of Health and 
Human Services determines that a cancer screening 
test described in paragraph (1) has a utilization rate 
of at least 75 percent of the Medicare beneficiaries 
for whom such screening has such a recommenda-
tion, effective as of the first day of the year after 
the year in which such determination is made, the 
VerDate Mar 15 2010 
00:24 Mar 28, 2013
Jkt 029200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H1320.IH
H1320
tjames on DSK6SPTVN1PROD with BILLS