To amend title XVIII of the Social Security Act to make a technical correction regarding purchase agreements for power-driven wheelchairs under the Medicare program, to provide for coverage of ultrasound screening for abdominal aortic aneurysms under part B of such program, to improve patient access to, and utilization of, the colorectal cancer screening benefit under such program, and to provide for the coverage of marriage and family therapist services and mental health counselor services under part B of such title.

1. Adds SEC. 6116. TECHNICAL CORRECTION REGARDING PURCHASE AGREEMENTS FOR POWER-DRIVEN WHEELCHAIRS on page 368, between lines 5 and 6

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   Inserted: SEC. 6116. TECHNICAL CORRECTION REGARDING PURCHASE AGREEMENTS FOR POWER-DRIVEN WHEELCHAIRS.

   Inserted: (a) In General.--Section 1834(a)(7)(A) (42 U.S.C. 1395m(a)(7)(A)), as amended by section 6109 of this Act, is amended--

   Inserted: (1) in clause (i)(I), by striking "Payment" and inserting "Except as provided in clause (iii), payment"; and

   Inserted: (2) by adding at the end the following new clause:

   Inserted: "(iii) Purchase agreement option for power-driven wheelchairs.--

   Inserted: "(I) In general.--In the case of a power-driven wheelchair, at the time the supplier furnishes the item, the supplier shall offer the individual the option to purchase the item, and payment for such item shall be made on a lump-sum basis if the individual exercises such option.

   Inserted: "(II) Maintenance and servicing.--In the case of a power-driven wheelchair for which a purchase agreement has been entered into under subclause (I), maintenance and servicing payments shall, if the Secretary determines such payments are reasonable and necessary, be made (for parts and labor not covered by the supplier's or manufacturer's warranty, as determined by the Secretary to be appropriate), and such payments shall be in an amount determined to be appropriate by the Secretary.".

   Inserted: (b) Effective Date.--The amendments made by subsection (a) shall apply to items furnished on or after October 1, 2006.

   Inserted: SEC. 6117. MEDICARE COVERAGE OF ULTRASOUND SCREENING FOR ABDOMINAL AORTIC ANEURYSMS; NATIONAL EDUCATIONAL AND INFORMATION CAMPAIGN.

   Inserted: (a) In General.--Section 1861 (42 U.S.C. 1395x) is amended--

   Inserted: (1) in subsection (s)(2)--

   Inserted: (A) by striking "and" at the end of subparagraph (Y);

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   Inserted: (B) by adding "and" at the end of subparagraph (Z); and

   Inserted: (C) by adding at the end the following new subparagraph:

   Inserted: "(AA) ultrasound screening for abdominal aortic aneurysm (as defined in subsection (bbb)) for an individual--

   Inserted: "(i) who receives a referral for such an ultrasound screening as a result of an initial preventive physical examination (as defined in section 1861(ww)(1));

   Inserted: "(ii) who has not been previously furnished such an ultrasound screening under this title; and

   Inserted: "(iii) who--

   Inserted: "(I) has a family history of abdominal aortic aneurysm; or

   Inserted: "(II) manifests risk factors included in a beneficiary category (not including categories related to age) recommended for screening by the United States Preventive Services Task Force regarding abdominal aortic aneurysms;"; and

   Inserted: (2) by adding at the end the following new subsection:

   Inserted: "Ultrasound Screening for Abdominal Aortic Aneurysm

   Inserted: "(bbb) The term 'ultrasound screening for abdominal aortic aneurysm' means--

   Inserted: "(1) a procedure using sound waves (or such other procedures using alternative technologies, of commensurate accuracy and cost, that the Secretary may specify) provided for the early detection of abdominal aortic aneurysm; and

   Inserted: "(2) includes a physician's interpretation of the results of the procedure.".

   Inserted: (b) Inclusion of Ultrasound Screening for Abdominal Aortic Aneurysm in Screening Services for Which Education, Counseling, and Referral Is Provided for Under Benefits for Initial Preventive Physical Examination.--Section 1861(ww)(2) (42 U.S.C. 1395x(ww)(2)) is amended by adding at the end the following new subparagraph:

   Inserted: "(L) Ultrasound screening for abdominal aortic aneurysm as defined in section 1861(bbb).".

   Inserted: (c) Payment for Ultrasound Screening for Abdominal Aortic Aneurysm.--Section 1848(j)(3) (42 U.S.C. 1395w-4(j)(3)) is amended by inserting "(2)(AA)," after "(2)(W),".

   Inserted: (d) Frequency and Quality Standards.--Section 1862(a)(1) (42 U.S.C. 1395y(a)(1)) is amended--

   Inserted: (1) by striking "and" at the end of subparagraph (L);

   Inserted: (2) by striking the semicolon at the end of subparagraph (M) and inserting ", and"; and

   Inserted: (3) by adding at the end the following new subparagraph:

   Inserted: "(N) in the case of ultrasound screening for abdominal aortic aneurysm--

   Inserted: "(i) which is performed more frequently than is provided for under section 1861(s)(2)(AA); or

   Inserted: "(ii) which is performed by an individual or diagnostic laboratory that does not meet quality assurance standards that the Secretary, in consultation with national medical, vascular technologist and sonographer societies, shall establish, including with respect to individuals performing ultrasound screening for abdominal aortic aneurysm (other than physicians) and diagnostic laboratories, that the individual or laboratory is certified by the appropriate State licensing or certification agency or, in the case of a service performed in a State that does not license or certify such individuals or laboratories, by a national certification or accreditation organization recognized by the Secretary;".

   Inserted: (e) Non-Application of Part B Deductible.--Section 1833(b) (42 U.S.C. 1395l(b)) is amended in the first sentence--

   Inserted: (1) by striking "and (6)" and inserting "(6)"; and

   Inserted: (2) by inserting ", and (7) such deductible shall not apply with respect to ultrasound screening for abdominal aortic aneurysm (as defined in section 1861(bbb))" before the period at the end.

   Inserted: (f) National Educational and Information Campaign.--

   Inserted: (1) In general.--After consultation with national medical, vascular technologist, and sonographer societies, the Secretary of Health and Human Services shall carry out a national education and information campaign to promote awareness among health care practitioners and the general public with respect to the importance of early detection and treatment of abdominal aortic aneurysms.

   Inserted: (2) Use of funds.--The Secretary may use amounts appropriated pursuant to this subsection to make grants to national medical, vascular technologist, and sonographer societies (in accordance with procedures and criteria specified by the Secretary) to enable them to educate practitioners and providers about matters relating to such aneurysms.

   Inserted: (3) Authorization of Appropriations.--There is authorized to be appropriated for fiscal year 2006 and each fiscal year thereafter such sums as may be necessary to carry out this subsection.

   Inserted: (g) Effective Date.--The amendments made by this section shall apply to ultrasound screenings for abdominal aortic aneurysm performed on or after January 1, 2007.

   Inserted: SEC. 6118. IMPROVING PATIENT ACCESS TO, AND UTILIZATION OF, COLORECTAL CANCER SCREENING UNDER MEDICARE.

   Inserted: (a) Increase in part B reimbursement for colorectal cancer screening and diagnostic tests.--

   Inserted: (1) In general.--Section 1834(d) (42 U.S.C. 1395m(d)) is amended by adding at the end the following new paragraph:

   Inserted: "(4) Enhanced part b payment for colorectal cancer screening and diagnostic tests.--

   Inserted: "(A) Nonfacility rates.--Notwithstanding paragraphs (2)(A) and (3)(A), the Secretary shall establish national minimum payment amounts for CPT codes 45378, 45380, and 45385, and HCPCS codes G0105 and GO121 for items and services furnished on or after January 1, 2007, which reflect a 5-percent increase above the relative value units in effect as the nonfacility rates for such codes on December 31, 2006, with such revised payment level to apply to items and services performed in a nonfacility setting.

   Inserted: "(B) Facility rates.--Notwithstanding paragraphs (2)(A) and (3)(A), the Secretary shall establish national minimum payment amounts for CPT codes 45378, 45380, and 45385, and HCPCS codes G0105 and GO121 for items and services furnished on or after January 1, 2007, which reflect a 5-percent increase above the relative value units in effect as the facility rates for such codes on December 31, 2006, with such revised payment level to apply to items and services performed in a facility setting.

   Inserted: "(C) Annual adjustments.--In the case of items and services furnished on or after January 1, 2007, the payment rates described in subparagraphs (A) and (B) shall, subject to the minimum payment amounts established in such subparagraphs, be adjusted annually as provided in section 1848.".

   Inserted: (2) No effect on hopd payments.--The Secretary shall not take into account the provisions of section 1834(d)(4) of the Social Security Act, as added by subsection (a), in determining the amount of payment for any covered OPD service under the prospective payment system for hospitals outpatient department services under section 1833(t) of such Act (42 U.S.C. 1395l(t)).

   Inserted: (b) Medicare Coverage of Office Visit or Consultation Prior to a Screening Colonoscopy or in Conjunction With a Beneficiary's Decision to Obtain Such a Screening.--

   Inserted: (1) Coverage.--Section 1861(s)(2) (42 U.S.C. 1395x(s)(2)), as amended by section 6117, is amended--

   Inserted: (A) in subparagraph (Z), by striking "and" at the end;

   Inserted: (B) in subparagraph (AA), by inserting "and" at the end; and

   Inserted: (C) by adding at the end the following new subparagraph:

   Inserted: "(BB) an outpatient office visit or consultation for the purpose of beneficiary education, assuring selection of the proper screening test, and securing information relating to the procedure and sedation of the beneficiary, prior to a colorectal cancer screening test consisting of a screening colonoscopy or in conjunction with the beneficiary's decision to obtain such a screening, regardless of whether such screening is medically indicated with respect to the beneficiary;".

   Inserted: (2) Payment.--

   Inserted: (A) In general.--Section 1833(a)(1) (42 U.S.C. 1395l(a)(1)) is amended--

   Inserted: (i) by striking "and" before "(V)"; and

   Inserted: (ii) by inserting before the semicolon at the end the following: ", and (W) with respect to an outpatient office visit or consultation under section 1861(s)(2)(BB), the amounts paid shall be 80 percent of the lesser of the actual charge or the amount established under section 1848".

   Inserted: (B) Payment under physician fee schedule.--Section 1848(j)(3) (42 U.S.C. 1395w-4(j)(3)), as amended by section 6117, is amended by inserting "(2)(BB)," after "(2)(AA),".

   Inserted: (C) Requirement for establishment of payment amount under physician fee schedule.--Section 1834(d) (42 U.S.C. 1395m(d)), as amended by subsection (a), is amended by adding at the end the following new paragraph:

   Inserted: "(5) Payment for outpatient office visit or consultation prior to screening colonoscopy.--With respect to an outpatient office visit or consultation under section 1861(s)(2)(BB), payment under section 1848 shall be consistent with the payment amounts for CPT codes 99203 and 99243.".

   Inserted: (3) Effective date.--The amendments made by this subsection shall apply to items and services provided on or after January 1, 2007.

   Inserted: (c) Waiver of Deductible for Colorectal Cancer Screening Tests.--

   Inserted: (1) In general.--Section 1833(b) (42 U.S.C. 1395l(b)), as amended by section 6117, is amended in the first sentence--

   Inserted: (A) by striking "and" before "(7)"; and

   Inserted: (B) by inserting before the period at the end the following: ", and (8) such deductible shall not apply with respect to colorectal cancer screening tests (as described in section 1861(pp)(1))".

   Inserted: (2) Conforming amendments.--Paragraphs (2)(C)(ii) and (3)(C)(ii) of section 1834(d) (42 U.S.C. 1395m(d)) are each amended--

   Inserted: (A) by striking "deductible and" in the heading; and

   Inserted: (B) in subclause (I), by striking "deductible or" each place it appears.

   Inserted: (3) Effective date.--The amendments made by this subsection shall apply to items and services furnished on or after January 1, 2007.

   Inserted: SEC. 6119. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES UNDER PART B OF THE MEDICARE PROGRAM.

   Inserted: (a) Coverage of Services.--

   Inserted: (1) In general.--Section 1861(s)(2) (42 U.S.C. 1395x(s)(2)), as amended by section 6118(b), is amended--

   Inserted: (A) in subparagraph (AA), by striking "and" after the semicolon at the end;

   Inserted: (B) in subparagraph (BB), by inserting "and" after the semicolon at the end; and

   Inserted: (C) by adding at the end the following new subparagraph:

   Inserted: "(CC) marriage and family therapist services (as defined in subsection (ccc)(1)) and mental health counselor services (as defined in subsection (ccc)(3));".

   Inserted: (2) Definitions.--Section 1861 (42 U.S.C. 1395x), as amended by section 6117, is amended by adding at the end the following new subsection:

   Inserted: "Marriage and Family Therapist Services; Marriage and Family Therapist; Mental Health Counselor Services; Mental Health Counselor

   Inserted: "(ccc)(1) The term 'marriage and family therapist services' means services performed by a marriage and family therapist (as defined in paragraph (2)) for the diagnosis and treatment of mental illnesses, which the marriage and family therapist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as an incident to a physician's professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.

   Inserted: "(2) The term 'marriage and family therapist' means an individual who--

   Inserted: "(A) possesses a master's or doctoral degree which qualifies for licensure or certification as a marriage and family therapist pursuant to State law;

   Inserted: "(B) after obtaining such degree has performed at least 2 years of clinical supervised experience in marriage and family therapy; and

   Inserted: "(C) in the case of an individual performing services in a State that provides for licensure or certification of marriage and family therapists, is licensed or certified as a marriage and family therapist in such State.

   Inserted: "(3) The term 'mental health counselor services' means services performed by a mental health counselor (as defined in paragraph (4)) for the diagnosis and treatment of mental illnesses which the mental health counselor is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician's professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.

   Inserted: "(4) The term 'mental health counselor' means an individual who--

   Inserted: "(A) possesses a master's or doctor's degree in mental health counseling or a related field;

   Inserted: "(B) after obtaining such a degree has performed at least 2 years of supervised mental health counselor practice; and

   Inserted: "(C) in the case of an individual performing services in a State that provides for licensure or certification of mental health counselors or professional counselors, is licensed or certified as a mental health counselor or professional counselor in such State.".

   Inserted: (3) Provision for payment under part b.--Section 1832(a)(2)(B) (42 U.S.C. 1395k(a)(2)(B)) is amended by adding at the end the following new clause:

   Inserted: "(v) marriage and family therapist services and mental health counselor services;".

   Inserted: (4) Amount of payment.--Section 1833(a)(1) (42 U.S.C. 1395l(a)(1)), as amended by section 6118, is amended--

   Inserted: (A) by striking "and (W)" and inserting "(W)"; and

   Inserted: (B) by inserting before the semicolon at the end the following: ", and (X) with respect to marriage and family therapist services and mental health counselor services under section 1861(s)(2)(CC), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or 75 percent of the amount determined for payment of a psychologist under subparagraph (L)".

   Inserted: (5) Exclusion of marriage and family therapist services and mental health counselor services from skilled nursing facility prospective payment system.--Section 1888(e)(2)(A)(ii) (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting "marriage and family therapist services (as defined in section 1861(ccc)(1)), mental health counselor services (as defined in section 1861(ccc)(3))," after "qualified psychologist services,".

   Inserted: (6) Inclusion of marriage and family therapists and mental health counselors as practitioners for assignment of claims.--Section 1842(b)(18)(C) (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clauses:

   Inserted: "(vii) A marriage and family therapist (as defined in section 1861(ccc)(2)).

   Inserted: "(viii) A mental health counselor (as defined in section 1861(ccc)(4)).".

   Inserted: (b) Coverage of Certain Mental Health Services Provided in Certain Settings.--

   Inserted: (1) Rural health clinics and federally qualified health centers.--Section 1861(aa)(1)(B) (42 U.S.C. 1395x(aa)(1)(B)) is amended by striking "or by a clinical social worker (as defined in subsection (hh)(1))," and inserting ", by a clinical social worker (as defined in subsection (hh)(1)), by a marriage and family therapist (as defined in subsection (ccc)(2)), or by a mental health counselor (as defined in subsection (ccc)(4)),".

   Inserted: (2) Hospice programs.--Section 1861(dd)(2)(B)(i)(III) (42 U.S.C. 1395x(dd)(2)(B)(i)(III)) is amended by inserting "or one marriage and family therapist (as defined in subsection (bbb)(2))" after "social worker".

   Inserted: (c) Effective Date.--The amendments made by this section shall apply with respect to services furnished on or after January 1, 2007.

   Original wording

   On page 368, between lines 5 and 6, insert the following:

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As printed