[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2523 Introduced in Senate (IS)]
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115th CONGRESS
2d Session
S. 2523
To amend title XVIII of the Social Security Act to provide coverage
under the Medicare program for FDA-approved qualifying colorectal
cancer screening blood-based tests, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 8, 2018
Mrs. Capito (for herself and Mr. Heinrich) 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 provide coverage
under the Medicare program for FDA-approved qualifying colorectal
cancer screening blood-based tests, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Colorectal Cancer Detection Act of
2018''.
SEC. 2. MEDICARE COVERAGE FOR FDA-APPROVED QUALIFYING COLORECTAL CANCER
SCREENING BLOOD-BASED TESTS.
(a) In General.--Section 1861(pp) of the Social Security Act (42
U.S.C. 1395x(pp)) is amended--
(1) in paragraph (1)--
(A) by redesignating subparagraph (D) as
subparagraph (E); and
(B) by inserting after subparagraph (C) the
following new subparagraph:
``(D) Qualifying colorectal cancer screening blood-based
test.''; and
(2) by adding at the end the following new paragraph:
``(3) The term `qualifying colorectal cancer screening blood-based
test' means, with respect to a year, a screening blood-based test for
the early detection of colorectal cancer furnished in the year that was
marketed or used, as applicable, in accordance with the relevant
provisions of section 353 of the Public Health Service Act or the
Federal Food, Drug, and Cosmetic Act more than 6 months before the
beginning of the year.''.
(b) Frequency Limits for Colorectal Cancer Screening Tests and
Payment Amount for Qualifying Colorectal Cancer Screening Blood-Based
Tests.--Section 1834(d) of the Social Security Act (42 U.S.C. 1395m(d))
is amended--
(1) by amending clause (ii) of paragraph (1)(B) to read as
follows:
``(ii) if the test is performed within--
``(I) the 11 months after a
previous screening fecal-occult blood
test or a previous qualifying
colorectal cancer screening blood-based
test;
``(II) the 35 months after a
previous screening flexible
sigmoidoscopy or a previous screening
colonoscopy with adenoma findings;
``(III) the 59 months after a
previous screening colonoscopy with
small polyp findings; or
``(IV) the 119 months after a
previous screening colonoscopy without
adenoma findings or small polyp
findings.'';
(2) in paragraph (2)(E)(ii), by inserting ``or within the
35 months after a previous screening fecal-occult blood test or
previous qualifying colorectal cancer screening blood-based
test'' after ``sigmoidoscopy'';
(3) by amending subparagraph (E) of paragraph (3) to read
as follows:
``(E) Frequency limit.--No payment may be made
under this part for a colorectal cancer screening test
consisting of a screening colonoscopy--
``(i) if the procedure is performed within
the 119 months after a previous screening
fecal-occult blood test or previous qualifying
colorectal cancer screening blood-based test;
``(ii) for individuals at high risk for
colorectal cancer if the procedure is performed
within the 23 months after a previous screening
colonoscopy; or
``(iii) for individuals not at high risk
for colorectal cancer if the procedure is
performed within the 119 months after a
previous screening colonoscopy or within the 47
months after a previous screening flexible
sigmoidoscopy.''; and
(4) by adding at the end the following new paragraph:
``(4) Qualifying colorectal cancer screening blood-based
tests.--
``(A) Payment amount.--The payment amount for
colorectal cancer screening tests consisting of
qualifying colorectal cancer screening blood-based
tests shall be established by the Secretary based on a
crosswalk to payment amounts for tests for the
diagnosis of inherited colorectal cancer by methylation
methods.
``(B) Frequency limit.--Paragraph (1)(B) shall
apply to colorectal cancer screening tests consisting
of qualifying colorectal cancer screening blood-based
tests in the same manner as such paragraph applies to
colorectal cancer screening tests consisting of fecal-
occult blood tests.''.
(c) Effective Date.--The amendments made by this section shall
apply to colorectal cancer screening tests furnished in a year
beginning more than 6 months after the date of the enactment of this
Act.
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