I 
110TH CONGRESS 
1ST SESSION H. R. 4206 
To amend title XVIII of the Social Security Act to improve access to, 
and increase utilization of, bone mass measurement benefits under the 
Medicare part B Program. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 15, 2007 
Ms. BERKLEY (for herself, Mr. BURGESS, Mrs. MALONEY of New York, Mr. 
MCNULTY, Mr. PAUL, Mr. ROTHMAN, Mr. GOODE, Mr. SESSIONS, Mrs. 
MYRICK, Mr. GENE GREEN of Texas, Mrs. CAPPS, Mr. KLEIN of Florida, 
Ms. LORETTA SANCHEZ of California, Ms. MOORE of Wisconsin, Ms. 
ROYBAL-ALLARD, Ms. LINDA T. SA´NCHEZ of California, Mrs. TAUSCHER, 
Ms. ZOE LOFGREN of California, Mrs. DAVIS of California, Ms. SOLIS, 
Ms. MATSUI, Mr. BERRY, Mr. HINCHEY, Ms. SCHAKOWSKY, Ms. GIF-
FORDS, Ms. CASTOR, Mrs. GILLIBRAND, Mr. ELLSWORTH, Ms. WOOLSEY, 
Ms. WATSON, Ms. BORDALLO, Ms. SCHWARTZ, Mr. ISRAEL, Ms. 
VELA´ZQUEZ, Mr. PASCRELL, Ms. MCCOLLUM of Minnesota, Mr. CROW-
LEY, Mr. HARE, Mr. JOHNSON of Georgia, Mrs. MCCARTHY of New 
York, Ms. HOOLEY, and Mrs. NAPOLITANO) 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 subse-
quently 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 improve 
access to, and increase utilization of, bone mass measure-
ment benefits under the Medicare part B Program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Fracture 
Prevention and Osteoporosis Testing Act of 2007’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Since 1997, Congress has recognized the 
importance of osteoporosis prevention by standard-
izing reimbursement under the Medicare program 
for bone mass measurement. 
(2) One decade later, osteoporosis remains 
underdiagnosed and untreated despite numerous 
Federal initiatives, including recommendations of the 
United States Preventive Services Task Force, the 
2004 United States Surgeon General’s Report on 
Bone Health and Osteoporosis, and inclusion of bone 
mass measurement in the Welcome to Medicare 
exam. 
(3) Even though osteoporosis is a highly man-
ageable disease, many patients lack access to early 
diagnosis that can prevent debilitating fractures, 
morbidity, and loss of mobility. 
(4) Although Caucasians are most likely to sus-
tain osteoporosis fractures, the cost of fractures 
among the nonwhite population is projected to in-
crease by as much as 180 percent over the next 20 
years. 
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(5) Black women are more likely than White 
women to die following a hip fracture. 
(6) Osteoporosis is a critical women’s health 
issue. Women account for 71 percent of fractures 
and 75 percent of osteoporosis-associated costs. 
(7) The World Health Organization, the Cen-
ters for Medicare & Medicaid Services, and other 
medical experts concur that the most widely accept-
ed method of measuring bone mass to predict frac-
ture risk is dual-energy x-ray absorptiometry (in this 
Act referred to as ‘‘DXA’’). Vertebral fracture as-
sessment (in this Act referred to as ‘‘VFA’’) is an-
other test used to identify patients at high risk for 
future fracture. 
(8) Unlike other imaging procedures, bone mass 
measurement testing remains severely underutilized 
with less than 20 percent of eligible Medicare bene-
ficiaries taking advantage of the benefit. 
(9) Underutilization of bone mass measurement 
will strain the Medicare budget because— 
(A) 55 percent of the people age 50 and 
older in 2002 had osteoporosis or low bone 
mass; 
(B) more than 61,000,000 people in the 
United States are projected to have osteoporosis 
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or low bone mass in 2020, as compared to 
43,000,000 in 2002; 
(C) osteoporosis fractures are projected to 
increase by almost 50 percent over the next 2 
decades with at least 3,000,000 fractures ex-
pected to occur annually by 2025; 
(D) the population aged 65 and older rep-
resents 89 percent of fracture costs; and 
(E) the economic burden of osteoporosis 
fractures are projected to increase by 50 per-
cent over the next 2 decades, reaching 
$25,300,000,000 in 2025. 
(10) Underutilization of bone mass measure-
ment will also strain the Medicaid budget, which 
funds treatment for osteoporosis in low-income 
Americans. 
(11) Reimbursement under the Medicare pro-
gram for DXA provided in physician offices and 
other non-hospital settings was reduced by 40 per-
cent and will be reduced by a total of 75 percent by 
2010. This drop represents one of the largest reim-
bursement reductions in the history of the Medicare 
program. Reimbursement for VFA will also be re-
duced by 50 percent by 2010. 
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(12) The reduction in reimbursement discour-
ages physicians from continuing to provide access to 
DXA or VFA in their offices. Since two-thirds of all 
DXA scans are performed in nonfacility settings, 
such as physician offices, patient access to bone 
mass measurement will be severely compromised 
when physicians discontinue providing those tests in 
their offices, thereby exacerbating the current under-
utilization of the benefit. 
SEC. 3. MINIMUM PAYMENT FOR BONE MASS MEASURE-
MENT. 
(a) IN GENERAL.—Section 1848(b) of the Social Se-
curity Act (42 U.S.C. 1395w–4(b)) is amended by adding 
at the end the following: 
‘‘(5) TREATMENT OF BONE MASS SCANS.—Not-
withstanding the provisions of paragraph (1), the 
Secretary shall establish a national minimum pay-
ment amount for CPT code 77080 (relating to dual- 
energy x-ray absorptiometry) and CPT code 77082 
(relating to vertebral fracture assessment), and any 
successor to such codes as identified by the Sec-
retary. Such minimum payment amount shall not be 
less than 100 percent of the reimbursement rates in 
effect for such codes (or predecessor codes) on De-
cember 31, 2006.’’. 
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