I 
113TH CONGRESS 
1ST SESSION H. R. 3705 
To amend title XVIII of the Social Security Act to establish appropriateness 
requirements for certain advanced diagnostic imaging services, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 11, 2013 
Mr. PAULSEN (for himself and Mr. MATHESON) 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 establish 
appropriateness requirements for certain advanced diag-
nostic imaging services, 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 ‘‘Excellence in Diag-
nostic Imaging Utilization Act of 2013’’. 
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SEC. 2. APPROPRIATENESS REQUIREMENTS FOR CERTAIN 
ADVANCED DIAGNOSTIC IMAGING SERVICES. 
(a) IN GENERAL.—Section 1834 of the Social Secu-
rity Act (42 U.S.C. 1395m) is amended by adding at the 
end the following new subsection: 
‘‘(p) APPROPRIATENESS REQUIREMENTS FOR CER-
TAIN ADVANCED DIAGNOSTIC IMAGING SERVICES.— 
‘‘(1) IN GENERAL.— 
‘‘(A) IN GENERAL.—Beginning with Janu-
ary 1, 2015, with respect to applicable ad-
vanced diagnostic imaging services furnished in 
an outpatient setting and for which payment is 
made under— 
‘‘(i) the technical or professional com-
ponent of the fee schedule established 
under section 1848(b); or 
‘‘(ii) the prospective payment system 
for hospital outpatient department services 
under section 1833(t), 
payment for such services may only be made if 
the requirements of this subsection are met. 
‘‘(B) APPLICABLE ADVANCED DIAGNOSTIC 
IMAGING SERVICES.—For purposes of this sub-
section, the term ‘applicable advanced diag-
nostic imaging services’ means advanced diag-
nostic imaging services (as defined in subsection 
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(e)(1)(B)) for which defined appropriate use 
criteria (and related guidelines) have been— 
‘‘(i) developed or endorsed by national 
professional medical specialty societies; and 
‘‘(ii) selected by the Secretary for pur-
poses of this subsection in consultation 
with national professional medical specialty 
societies and other stakeholders. 
‘‘(C) CONSTRUCTION
IN
INSTANCES
OF 
MULTIPLE APPLICABLE APPROPRIATE USE CRI-
TERIA.—Nothing in this subsection shall be 
construed as preventing the Secretary, in the 
case that there are multiple appropriate use cri-
teria (and related guidelines) that are applica-
ble to a particular advanced diagnostic imaging 
service (or a specific set of clinical indications), 
from selecting more than one criterion (or more 
than 
one 
guideline) 
under 
subparagraph 
(B)(ii)(II). 
‘‘(D) PERIODIC REVISION.—The Secretary 
may periodically revise the list of applicable ad-
vanced diagnostic imaging services under this 
paragraph. 
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