radioisotopic procedure or other procedure approved 
by the Food and Drug Administration performed on 
an individual for the purpose of identifying bone 
mass or detecting bone loss or determining bone 
quality, and includes a physician’s interpretation of 
the results of the procedure. Nothing in this para-
graph shall be construed as requiring a bone mass 
measurement to be conducted in a particular type of 
facility or to prevent such a measurement from 
being conducted through the use of mobile facilities 
that are otherwise qualified. 
‘‘(2) QUALIFIED INDIVIDUAL.—The term ‘quali-
fied individual’ means an individual who— 
‘‘(A) is at clinical risk for osteoporosis, in-
cluding an estrogen-deficient woman; 
‘‘(B) has vertebral abnormalities; 
‘‘(C) is receiving chemotherapy or long- 
term gluococorticoid (steroid) therapy; 
‘‘(D) has primary hyperparathyroidism, 
hyperthyroidism, or excess thyroid replacement; 
or 
‘‘(E) is being monitored to assess the re-
sponse to or efficacy of approved osteoporosis 
drug therapy.
‘‘(c) LIMITATION ON FREQUENCY REQUIRED.—The 
standards established under section 2707(c) of the Public 
Health Service Act shall apply to benefits provided under 
this section in the same manner as they apply to benefits 
provided under section 2707 of such Act. 
‘‘(d) RESTRICTIONS ON COST-SHARING.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
nothing in this section shall be construed as pre-
venting a group health plan or issuer from imposing 
deductibles, coinsurance, or other cost-sharing in re-
lation to bone mass measurement under the plan (or 
health insurance coverage offered in connection with 
a plan). 
‘‘(2) LIMITATION.—Deductibles, coinsurance, 
and other cost-sharing or other limitations for bone 
mass measurement may not be imposed under para-
graph (1) to the extent they exceed the deductibles, 
coinsurance, and limitations that are applied to simi-
lar services under the group health plan or health 
insurance coverage. 
‘‘(e) PROHIBITIONS.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage in connection with a group health plan, may 
not—
‘‘(1) deny to an individual eligibility, or contin-
ued eligibility, to enroll or to renew coverage under 
the terms of the plan, solely for the purpose of 
avoiding the requirements of this section; 
‘‘(2) provide incentives (monetary or otherwise) 
to individuals to encourage such individuals not to 
be provided bone mass measurements to which they 
are entitled under this section or to providers to in-
duce such providers not to provide such measure-
ments to qualified individuals; 
‘‘(3) prohibit a provider from discussing with a 
patient osteoporosis preventive techniques or medical 
treatment options relating to this section; or 
‘‘(4) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided bone mass measurements to a qualified in-
dividual in accordance with this section. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require an individual who is a 
participant or beneficiary to undergo bone mass measure-
ment. 
‘‘(g) NOTICE UNDER GROUP HEALTH PLAN.—The 
imposition of the requirements of this section shall be 
treated as a material modification in the terms of the plan 
described in section 102(a)(1), for purposes of assuring
notice of such requirements under the plan; except that 
the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such 
modification shall be provided by not later than 60 days 
after the first day of the first plan year in which such 
requirements apply. 
‘‘(h) PREEMPTION.— 
‘‘(1) IN GENERAL.—The provisions of this sec-
tion do not preempt State law relating to health in-
surance coverage to the extent such State law pro-
vides greater benefits with respect to osteoporosis 
detection or prevention. 
‘‘(2) CONSTRUCTION.—Section 731(a)(1) shall 
not be construed as superseding a State law de-
scribed in paragraph (1).’’. 
(B) Section 731(c) of such Act (29 U.S.C. 
1191(c)) is amended by striking ‘‘section 711’’ and 
inserting ‘‘sections 711 and 714’’. 
(C) Section 732(a) of such Act (29 U.S.C. 
1191a(a)) is amended by striking ‘‘section 711’’ and 
inserting ‘‘sections 711 and 714’’. 
(D) The table of contents in section 1 of such 
Act is amended by inserting after the item relating 
to section 712 the following new item: 
‘‘714. Standards relating to benefits for bone mass measurement.’’.
(b) INDIVIDUAL HEALTH INSURANCE.—(1) Part B 
of title XXVII of the Public Health Service Act is amend-
ed by inserting after section 2752 the following new sec-
tion: 
‘‘SEC. 2753. STANDARDS RELATING TO BENEFITS FOR BONE 
MASS MEASUREMENT. 
‘‘(a) IN GENERAL.—The provisions of section 2707 
(other than subsection (g)) shall apply to health insurance 
coverage offered by a health insurance issuer in the indi-
vidual market in the same manner as it applies to health 
insurance coverage offered by a health insurance issuer 
in connection with a group health plan in the small or 
large group market. 
‘‘(b) NOTICE.—A health insurance issuer under this 
part shall comply with the notice requirement under sec-
tion 714(g) of the Employee Retirement Income Security 
Act of 1974 with respect to the requirements referred to 
in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan. 
‘‘(c) PREEMPTION.— 
‘‘(1) IN GENERAL.—The provisions of this sec-
tion do not preempt State law relating to health in-
surance coverage to the extent such State law pro-
vides greater benefits with respect to osteoporosis 
detection or prevention.
‘‘(2) CONSTRUCTION.—Section 2762(a) shall 
not be construed as superseding a State law de-
scribed in paragraph (1).’’. 
(2) Section 2762(b)(2) of such Act (42 U.S.C. 
300gg–62(b)(2)) is amended by striking ‘‘section 2751’’ 
and inserting ‘‘sections 2751 and 2753’’. 
(c) EFFECTIVE DATES.—(1) The amendments made 
by subsection (a) shall apply with respect to group health 
plans for plan years beginning on or after January 1, 
2005. 
(2) The amendments made by subsection (b) shall 
apply with respect to health insurance coverage offered, 
sold, issued, renewed, in effect, or operated in the indi-
vidual market on or after such date. 
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