I
103D CONGRESS
1ST SESSION
H. R. 2916
To amend title XVIII of the Social Security Act to provide for coverage
of a comprehensive health assessment and certain immunizations under
part B of the medicare program, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 6, 1993
Mr. BILIRAKIS introduced the following bill; which was referred jointly to the
Committees on Ways and Means and Energy and Commerce
A BILL
To amend title XVIII of the Social Security Act to provide
for coverage of a comprehensive health assessment and
certain immunizations under part B of the medicare
program, 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 ‘‘Older Americans Pre-
ventive Health Act of 1993’’.
SEC. 
2. 
MEDICARE 
COVERAGE 
OF 
COMPREHENSIVE
HEALTH ASSESSMENT.
(a) IN GENERAL.—Section 1861(s)(2) of the Social
Security Act (42 U.S.C. 1395x(s)(2)) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (O);
(2) by striking the semicolon at the end of sub-
paragraph (P) and inserting ‘‘; and’’; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(Q) comprehensive health assessment (as de-
fined in subsection (oo));’’.
(b) COMPREHENSIVE HEALTH ASSESSMENT DE-
FINED.—Section 1861 of such Act (42 U.S.C. 1395x) is
amended by adding at the end the following new sub-
section:
‘‘COMPREHENSIVE HEALTH ASSESSMENT
‘‘(oo)(1) The term ‘comprehensive health assessment’
means a procedure conducted by a primary care physician
(as defined in paragraph (3)) that is provided to an indi-
vidual enrolled under part B who elects to receive coverage
for such assessment (at such time and in such manner
as the Secretary may provide by regulation) and that con-
sists of the following examinations, tests, and procedures:
‘‘(A) The taking of a health history.
‘‘(B) A physical examination, including an ex-
amination for height, weight, blood pressure, visual
acuity, hearing, and palpation for pre-clinical dis-
ease.
‘‘(C) Laboratory and screening procedures, in-
cluding—
‘‘(i) nonfasting total blood cholesterol;
‘‘(ii) fecal occult blood testing, and
‘‘(iii) sigmoidoscopy (in accordance with a
periodicity schedule established by the Sec-
retary).
‘‘(D) Counseling services, including counseling
relating to—
‘‘(i) exercise;
‘‘(ii) smoking cessation;
‘‘(iii) substance abuse prevention;
‘‘(iv) injury prevention;
‘‘(v) dental health;
‘‘(vi) prescription drug use;
‘‘(vii) the need to visit eye specialists for
glaucoma testing;
‘‘(viii) diet;
‘‘(ix) in the case of women, the need for
regular mammograms and pap smears; and
‘‘(x) in the case of individuals identified as
being at high risk for specific medical condi-
tions, counseling for—
‘‘(I) estrogen replacement therapy,
‘‘(II) aspirin therapy, and
‘‘(III) skin protection from ultraviolet
light.
‘‘(2) For purposes of this subsection, the term ‘pri-
mary care physician’ includes a physician (described in
section 1861(r)(1)) who is a family practitioner, general
practitioner, internal medicine specialist, general preven-
tive medicine specialist, obstetrical or gynecological spe-
cialist, pediatrician.’’.
(c) 
AMOUNT
OF
PAYMENT; 
WAIVER
OF
COPAYMENT.—(1) Section 1833(a)(1) of such Act (42
U.S.C. 1395l(a)(1)) is amended—
(A) by striking ‘‘1834(h)(1), (M)’’ and inserting
‘‘1834(h)(1), (N)’’;
(B) by striking ‘‘(r)(2)) and (N)’’ and inserting
‘‘(r)(2)), (O)’’; and
(C) by striking the semicolon at the end and in-
serting the following: ‘‘, and (P) with respect to ex-
penses incurred for a comprehensive health assess-
ment (as described in section 1861(oo)), the
amounts paid shall be 100 percent of the reasonable
charge for such assessment or the fee schedule
amount determined under section 1848 for such as-
sessment;’’.
(2) The second to last sentence of section
1866(a)(2)(A) of such Act (42 U.S.C. 1395cc(a)(2)(A))
is amended by inserting after ‘‘with the first opinion),’’
the following: ‘‘with respect to a comprehensive health as-
sessment (as described in section 1861(oo)),’’.
(d) FINANCING THROUGH INCREASE
IN PART B
PREMIUM.—Section 1839 of such Act (42 U.S.C. 1395r)
is amended by adding at the end the following new sub-
section:
‘‘(g) Notwithstanding any other provision of this sec-
tion, in the case of an individual enrolled under this part
who elects to receive coverage for a comprehensive health
assessment pursuant to section 1861(oo)(1) for months in
a calendar year, the amount of the monthly premium oth-
erwise applicable to the individual under this section for
months in such year shall be increased by such amount
as the Secretary determines to be necessary to ensure that
the amount of expenditures made under this part during
the year as a result of the enactment of the Older Ameri-
cans Preventive Health Act of 1993 will not exceed the
amount of expenditures that would have been made under
this part during the year if such Act had not been enacted
into law.’’.
(e) EFFECTIVE DATE.—The amendments made by
this sections shall apply to services furnished on or after
January 1, 1994.
SEC. 2. MEDICARE COVERAGE OF CERTAIN IMMUNIZA-
TIONS.
(a) IN GENERAL.—Section 1861(s)(10) of the Social
Security Act (42 U.S.C. 1395x(s)(10)) is amended—
(1) in subparagraph (A), by striking ‘‘; and’’
and inserting a comma;
(2) in subparagraph (B), by striking the semi-
colon at the end and inserting ‘‘, and’’; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(C) such immunizations as the Secretary des-
ignates for prevention or treatment of tuberculosis,
meningococcal meningitis, tetanus, diptheria, and
such other infectious diseases as the Secretary deter-
mines present a public health problem, furnished to
individuals who, as determined in accordance with
regulations promulgated by the Secretary, are at
high risk of contracting any of such diseases;’’.
(b) 
WAIVER
OF
COPAYMENT.—(1) 
Section
1833(a)(1)(B) of such Act (42 U.S.C. 1395l(a)(1)(B)) is
amended by striking ‘‘1861(s)(10)(A)’’ and inserting
‘‘1861(s)(10)’’.
(2) The third sentence of section 1866(a)(2)(A) of
such Act (42 U.S.C. 1395cc(a)(2)(A)) is amended by
striking ‘‘1861(s)(10)(A)’’ and inserting ‘‘1861(s)(10)’’.
(c) EFFECTIVE DATE.—The amendments made by
subsections (a) and (b) shall apply to items and services
furnished on or after January 1, 1994.
SEC. 3. ADDITIONAL AUTHORIZATION OF APPROPRIATIONS
FOR PROVISION OF EDUCATION AND INFOR-
MATION REGARDING CANCER.
Section 408(a)(1) of the Public Health Service Act
(42 U.S.C. 284c(a)(1)) is amended by adding at the end
the following new subparagraph:
‘‘(C)(i) Subject to clause (ii), for the purpose of
providing under sections 412 and 413 education and
information regarding cancer to health professionals
and the public, there are authorized to be appro-
priated such sums as may be necessary for each of
the fiscal years 1994 through 1996. The authoriza-
tion of appropriations established in the preceding
sentence is in addition to any other authorization of
appropriations that is available for such purpose.
‘‘(ii) In carrying out the purpose described in
clause (i) with amounts appropriated under such
clause, the Director of the Cancer Institute shall
give priority to carrying out the purpose with respect
to low-income individuals.’’.
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