S. 2115

Medicare Preventive Services Coverage Act of 2007

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II

110th CONGRESS

1st Session

S. 2115

IN THE SENATE OF THE UNITED STATES

September 27, 2007

Mr. Cardin introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to extend for 6 months the eligibility period for the Welcome to Medicare physical examination and to provide for the coverage and waiver of cost-sharing for preventive services under the Medicare program.

1.

Short title

This Act may be cited as the Medicare Preventive Services Coverage Act of 2007.

2.

Extending the eligibility period for a Welcome to Medicare physical examination from six months to one year

(a)

In general

Section 1862(a)(1)(K) of the Social Security Act (42 U.S.C. 1395y(a)(1)(K)) is amended by striking 6 months and inserting 1 year.

(b)

Effective date

The amendment made by subsection (a) shall apply to initial preventive physician examinations performed on or after January 1, 2008.

3.

Coverage and waiver of cost-sharing for preventive services

(a)

Preventive services defined; coverage of additional preventive services

Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—

(1)

in subsection (s)(2)—

(A)

in subparagraph (Z), by striking and after the semicolon at the end;

(B)

in subparagraph (AA), by adding and after the semicolon at the end; and

(C)

by adding at the end the following new subparagraph:

(BB)

additional preventive services (described in subsection (ccc)(1)(O));

; and

(2)

by adding at the end the following new subsection:

(ccc)

Preventive services

(1)

The term preventive services means the following:

(A)

Prostate cancer screening tests (as defined in subsection (oo)).

(B)

Colorectal cancer screening tests (as defined in subsection (pp)).

(C)

Diabetes outpatient self-management training services (as defined in subsection (qq)).

(D)

Screening for glaucoma for certain individuals (as described in subsection (s)(2)(U)).

(E)

Medical nutrition therapy services for certain individuals (as described in subsection (s)(2)(V)).

(F)

An initial preventive physical examination (as defined in subsection (ww)).

(G)

Cardiovascular screening blood tests (as defined in subsection (xx)(1)).

(H)

Diabetes screening tests (as defined in subsection (yy)).

(I)

Ultrasound screening for abdominal aortic aneurysm for certain individuals (as described in subsection (s)(2)(AA)).

(J)

Pneumococcal and influenza vaccine and their administration (as described in subsection (s)(10)(A)).

(K)

Hepatitis B vaccine and its administration for certain individuals (as described in subsection (s)(10)(B)).

(L)

Screening mammography (as defined in subsection (jj)).

(M)

Screening pap smear and screening pelvic exam (as described in subsection (s)(14)).

(N)

Bone mass measurement (as defined in subsection (rr)).

(O)

Additional preventive services (as determined under paragraph (2)).

(2)
(A)

The term additional preventive services means items and services, including mental health services, not described in subparagraphs (A) through (N) of paragraph (1) that the Secretary determines to be reasonable and necessary for the prevention or early detection of an illness or disability.

(B)

In making determinations under subparagraph (A), the Secretary shall—

(i)

take into account evidence-based recommendations by the United States Preventive Services Task Force and other appropriate organizations; and

(ii)

use the process for making national coverage determinations (as defined in section 1869(f)(1)(B)) under this title.

.

(b)

Payment and Elimination of Cost-sharing

(1)

In general

(A)

In general

Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended—

(i)

in clause (T), by striking 80 percent and inserting 100 percent;

(ii)

by striking and before (V); and

(iii)

by inserting before the semicolon at the end the following: , and (W) with respect to additional preventive services (as defined in section 1861(ccc)(2)) and other preventive services for which a payment rate is not otherwise established under this section, the amount paid shall be 100 percent of the lesser of the actual charge for the services or the amount determined under a fee schedule established by the Secretary for purposes of this clause.

(B)

Application to sigmoidoscopies and colonoscopies

Section 1834(d) of the Social Security Act (42 U.S.C. 1395m(d)) is amended—

(i)

in paragraph (2)(C), by amending clause (ii) to read as follows:

(ii)

No coinsurance

In the case of a beneficiary who receives services described in clause (i), there shall be no coinsurance applied.

; and

(ii)

in paragraph (3)(C), by amending clause (ii) to read as follows:

(ii)

No coinsurance

In the case of a beneficiary who receives services described in clause (i), there shall be no coinsurance applied.

.

(2)

Elimination of coinsurance in outpatient hospital settings

(A)

Exclusion from OPD fee schedule

Section 1833(t)(1)(B)(iv) of the Social Security Act (42 U.S.C. 1395l(t)(1)(B)(iv)) is amended by striking screening mammography (as defined in section 1861(jj)) and diagnostic mammography and inserting diagnostic mammography and preventive services (as defined in section 1861(ccc)(1)).

(B)

Conforming amendments

Section 1833(a)(2) of the Social Security Act (42 U.S.C. 1395l(a)(2)) is amended—

(i)

in subparagraph (F), by striking and after the semicolon at the end;

(ii)

in subparagraph (G)(ii), by adding and at the end; and

(iii)

by adding at the end the following new subparagraph:

(H)

with respect to additional preventive services (as defined in section 1861(ccc)(2)) furnished by an outpatient department of a hospital, the amount determined under paragraph (1)(W);

.

(3)

Waiver of application of deductible for all preventive services

The first sentence of section 1833(b) of the Social Security Act (42 U.S.C. 1395l(b)) is amended—

(A)

in clause (1), by striking items and services described in section 1861(s)(10)(A) and inserting preventive services (as defined in section 1861(ccc)(1));

(B)

by inserting and before (4); and

(C)

by striking clauses (5) through (8).

(c)

Inclusion as part of initial preventive physical examination

Section 1861(ww)(2) of the Social Security Act (42 U.S.C. 1395x(ww)(2)) is amended by adding at the end the following new subparagraph:

(M)

Additional preventive services (as defined in subsection (ccc)(2)).

.

(d)

Effective date

The amendments made by this section shall apply to services furnished on or after January 1, 2008.