[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 3160 Introduced in Senate (IS)]
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115th CONGRESS
2d Session
S. 3160
To amend title XVIII of the Social Security Act to improve access to,
and utilization of, bone mass measurement benefits under part B of the
Medicare program by establishing a minimum payment amount under such
part for bone mass measurement.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 28, 2018
Ms. Collins (for herself, Mr. Cardin, Mr. Wicker, Mr. King, and Ms.
Stabenow) 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 improve access to,
and utilization of, bone mass measurement benefits under part B of the
Medicare program by establishing a minimum payment amount under such
part for bone mass measurement.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. FINDINGS.
The Congress finds the following:
(1) Osteoporosis is a major public health problem with 54
million Americans as of 2010 having either low bone mass or
osteoporosis, responsible for over 2 million fractures per
year, including over 300,000 hip fractures. The estimated total
cost of these fractures in 2005 was $17 billion and expected to
rise to over $25 billion by 2025.
(2) Osteoporosis is a silent disease that often is not
discovered until a fracture occurs. One out of two women and up
to one of four men will suffer an osteoporotic fracture in
their lifetimes.
(3) While both men and women may develop osteoporosis, 80
percent are women.
(4) Most women are not aware of their personal risk factors
for osteoporosis, the prevalence of, or the morbidity and
mortality associated with the disease, despite the fact that
broken bones due to osteoporosis lead to more hospitalizations
and greater health care costs than heart attack, stroke, or
breast cancer in women age 55 and above.
(5) A woman's risk of hip fracture is equal to her combined
risk of breast, uterine, and ovarian cancer. More women die in
the United States in the year following a hip fracture than
from breast cancer.
(6) One out of four people who have an osteoporotic hip
fracture will need long-term nursing home care. Half of those
who experience osteoporotic hip fractures are unable to walk
without assistance.
(7) Elderly women are so afraid of losing their
independence that eight in ten would rather die than break
their hip and be admitted to a nursing home.
(8) Bone density testing is more powerful in predicting
fractures than cholesterol is in predicting myocardial
infarction or blood pressure in predicting stroke.
(9) Osteoporosis remains both under-recognized and under-
treated. Over a 7-year period (2007-2013), 45 percent of older
female Medicare beneficiaries had no DXA bone density test, and
25 percent had only one test.
(10) DXA testing in older women declined in 2014 to the
lowest point in 10 years.
(11) A decade of steady decline in hip fractures stopped
abruptly in 2013. Since then, there have been more than 14,000
additional hip fractures, costing over $560 million, leading to
2,800 more deaths than expected if the decline had continued.
SEC. 2. INCREASING ACCESS TO OSTEOPOROSIS PREVENTION AND TREATMENT.
Section 1848(b) of the Social Security Act (42 U.S.C. 1395w-4(b))
is amended--
(1) in paragraph (4)(B)--
(A) by striking ``and the first 2 months of 2012''
and inserting ``the first 2 months of 2012, 2019, and
each subsequent year''; and
(B) by striking ``paragraph (6)'' and inserting
``paragraphs (6) and (12)''; and
(2) by adding at the end the following:
``(12) Establishing minimum payment for osteoporosis
tests.--For dual-energy x-ray absorptiometry services
(identified by HCPCS codes 77080 and 77082 and successor codes
77085 and 77086 (and any succeeding codes)) furnished during
2017 or a subsequent year, the Secretary shall establish a
national minimum payment amount under this subsection--
``(A) for such services identified by HCPCS code
77080, equal to $98 (with national minimum payment
amounts of $87.11 for the technical component and
$10.89 for the professional component);
``(B) for such services identified by HCPCS code
77086, equal to $35 (with national minimum payment
amounts of $27.18 for the technical component and $7.82
for the professional component); and
``(C) for the bundled code for dual energy
absorptiometry and vertebral fracture assessment
studies identified as HCPCS code 77085, equal to $133
(with national minimum payment amounts of $114.29 for
the technical component and $18.71 for the professional
component).
Such minimum payment amounts shall be adjusted by the
geographical adjustment factor established under subsection
(e)(2) for the services for the respective year.''.
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