I 
114TH CONGRESS 
1ST SESSION H. R. 2550 
To amend title XVIII of the Social Security Act to provide Medicare payment 
incentives to transition from traditional x-ray imaging to digital radiog-
raphy, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 21, 2015 
Mrs. MCMORRIS RODGERS introduced the following bill; which was referred 
to the Committee on Energy and Commerce, and in addition to the Com-
mittee 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 
Medicare payment incentives to transition from tradi-
tional x-ray imaging to digital radiography, 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 ‘‘Medical Imaging Mod-
ernization Act of 2015’’. 
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SEC. 2. MEDICARE PAYMENT INCENTIVE FOR THE TRANSI-
TION FROM TRADITIONAL X-RAY IMAGING TO 
DIGITAL RADIOGRAPHY AND OTHER MEDI-
CARE IMAGING PAYMENT PROVISION. 
(a) PHYSICIAN FEE SCHEDULE.— 
(1) PAYMENT INCENTIVE FOR TRANSITION.— 
(A) IN GENERAL.—Section 1848(b) of the 
Social Security Act (42 U.S.C. 1395w–4(b)) is 
amended by adding at the end the following 
new paragraph: 
‘‘(9) SPECIAL RULE TO INCENTIVIZE TRANSI-
TION FROM TRADITIONAL X-RAY IMAGING TO DIG-
ITAL RADIOGRAPHY.— 
‘‘(A) LIMITATION ON PAYMENT FOR FILM 
X-RAY IMAGING SERVICES.—In the case of im-
aging services that are X-rays taken using film 
and that are furnished during 2017 or a subse-
quent year, the payment amount for the tech-
nical component (including the technical compo-
nent portion of a global fee) of such services 
that would otherwise be determined under this 
section (without application of this paragraph 
and before application of any other adjustment 
under this section) for such year shall be re-
duced by 20 percent. 
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‘‘(B) PHASED-IN LIMITATION ON PAYMENT 
FOR COMPUTED RADIOGRAPHY IMAGING SERV-
ICES.—In the case of imaging services that are 
X-rays taken using computed radiography tech-
nology— 
‘‘(i) in the case of such services fur-
nished during 2018, 2019, 2020, 2021, or 
2022 the payment amount for the tech-
nical component (including the technical 
component portion of a global fee) of such 
services that would otherwise be deter-
mined under this section (without applica-
tion of this paragraph and before applica-
tion of any other adjustment under this 
section) for such year shall be reduced by 
7 percent; and 
‘‘(ii) in the case of such services fur-
nished during 2023 or a subsequent year, 
the payment amount for the technical com-
ponent (including the technical component 
portion of a global fee) of such services 
that would otherwise be determined under 
this section (without application of this 
paragraph and before application of any 
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other adjustment under this section) for 
such year shall be reduced by 10 percent. 
‘‘(C) COMPUTED
RADIOGRAPHY
TECH-
NOLOGY DEFINED.—For purposes of this para-
graph, the term ‘computed radiography tech-
nology’ means cassette-based imaging which 
utilizes an imaging plate to create the image in-
volved. 
‘‘(D) IMPLEMENTATION.—In order to im-
plement this paragraph, the Secretary shall 
adopt appropriate mechanisms which may in-
clude use of modifiers.’’. 
(B) EXEMPTION
FROM
BUDGET
NEU-
TRALITY.—Section 1848(c)(2)(B)(v) of the So-
cial 
Security 
Act 
(42 
U.S.C. 
1395w– 
4(c)(2)(B)(v)) is amended, by adding at the end 
the following new subclause: 
‘‘(X) REDUCED
EXPENDITURES 
ATTRIBUTABLE
TO
INCENTIVES
TO 
TRANSITION
TO
DIGITAL
RADIOG-
RAPHY.—Effective for fee schedules 
established beginning with 2017, re-
duced expenditures attributable to 
subparagraph (A) of subsection (b)(9) 
and effective for fee schedules estab-
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lished beginning with 2018, reduced 
expenditures attributable to subpara-
graph (B) of such subsection.’’. 
(2) ELIMINATION
OF
APPLICATION
OF
MUL-
TIPLE PROCEDURE PAYMENT REDUCTION.—Section 
1848(b)(4) of the Social Security Act (42 U.S.C. 
1395w–4(b)(4)) is amended by adding at the end 
the following new subparagraph: 
‘‘(E) ELIMINATION
OF
APPLICATION
OF 
MULTIPLE
PROCEDURE
PAYMENT
REDUC-
TION.— 
‘‘(i) IN
GENERAL.—Not later than 
January 1, 2016, the Secretary shall not 
apply a multiple procedure payment reduc-
tion policy to the professional component 
of imaging services furnished in any subse-
quent year that is prior to a year in which 
the Secretary conducts and publishes, as 
part of the Medicare Physician Fee Sched-
ule Proposed Rule for a year, the empirical 
analysis described in clause (ii). 
‘‘(ii) 
EMPIRICAL
ANALYSIS
DE-
SCRIBED.—The 
empirical 
analysis 
de-
scribed in this clause is an analysis of the 
Resource-Based Relative Value Scale (com-
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monly known as the ‘RBRVS’) Data Man-
ager information that is used to determine 
what, if any, efficiencies exist within the 
professional component of imaging services 
when two or more studies are performed 
on the same patient on the same day. Such 
empirical analysis shall include— 
‘‘(I) work sheets and other infor-
mation detailing which physician work 
activities performed given the typical 
vignettes were assigned reduction per-
centages of 0, 25, 50, 75 and 100 
percent; 
‘‘(II) a discussion of the clinical 
aspects that informed the assignment 
of the reduction percentages described 
in subclause (I); 
‘‘(III) an explanation of how the 
percentage reductions for pre-, intra 
and post-service work were deter-
mined and calculated; and 
‘‘(IV) a demonstration that the 
Centers for Medicare & Medicaid 
Services has consulted with practicing 
radiologists to gain knowledge of how 
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radiologists interpret studies of mul-
tiple body parts on the same indi-
vidual on the same day.’’. 
(b) PAYMENT INCENTIVE FOR TRANSITION UNDER 
HOSPITAL OUTPATIENT PROSPECTIVE PAYMENT SYS-
TEM.—Section 1833(t)(16) of the Social Security Act (42 
U.S.C. 1395(t)(16)) is amended by adding at the end the 
following new subparagraph: 
‘‘(F) PAYMENT INCENTIVE FOR THE TRAN-
SITION FROM TRADITIONAL X-RAY IMAGING TO 
DIGITAL
RADIOGRAPHY.—Notwithstanding the 
previous provisions of this subsection: 
‘‘(i) LIMITATION
ON
PAYMENT
FOR 
FILM
X-RAY
IMAGING
SERVICES.—In the 
case of imaging services that are X-rays 
taken using film and that are furnished 
during 2017 or a subsequent year, the pay-
ment amount for the technical component 
(including the technical component portion 
of a global fee) of such services that would 
otherwise be determined under this section 
(without application of this paragraph and 
before application of any other adjustment 
under this subsection) for such year shall 
be reduced by 20 percent. 
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‘‘(ii) PHASED-IN LIMITATION ON PAY-
MENT FOR COMPUTED RADIOGRAPHY IM-
AGING SERVICES.—In the case of imaging 
services that are X-rays taken using com-
puted radiography technology (as defined 
in section 1848(b)(9)(C))— 
‘‘(I) in the case of such services 
furnished during 2018, 2019, 2020, 
2021, or 2022 the payment amount 
for the technical component (including 
the technical component portion of a 
global fee) of such services that would 
otherwise be determined under this 
section (without application of this 
paragraph and before application of 
any other adjustment under this sub-
section) for such year shall be reduced 
by 7 percent; and 
‘‘(II) in the case of such services 
furnished during 2023 or a subse-
quent year, the payment amount for 
the technical component (including 
the technical component portion of a 
global fee) of such services that would 
otherwise be determined under this 
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section (without application of this 
paragraph and before application of 
any other adjustment under this sub-
section) for such year shall be reduced 
by 10 percent. 
‘‘(iii) APPLICATION WITHOUT REGARD 
TO BUDGET NEUTRALITY.—The reductions 
made under this paragraph— 
‘‘(I) shall not be considered an 
adjustment under paragraph (2)(E); 
and 
‘‘(II) shall not be implemented in 
a budget neutral manner.’’. 
Æ 
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