STANDARDIZATION OF MEDICARE COVERAGE OF BONE MASS MEASUREMENTS.

SEC. 4106. STANDARDIZATION OF MEDICARE COVERAGE OF BONE MASS MEASUREMENTS. (a) In General.—Section 1861 (42 U.S.C. 1395x), as amended by sections 4103(a), 4104(a), and 4105(a), is amended— (1) in subsection (s)— (A) in paragraph (12)(C), by striking “and” at the end, (B) by striking the period at the end of paragraph (14) and inserting “; and”,111 STAT. 368 (C) by redesignating paragraphs (15) and (16) as paragraphs (16) and (17), respectively, and (D) by inserting after paragraph (14) the following new paragraph: “(15) bone mass measurement (as defined in subsection (rr)).”; and (2) by inserting after subsection (qq) the following new subsection: “Bone Mass Measurement “(rr)(1) The term ‘bone mass measurement’ means a radiologic or radioisotopic procedure or other procedure approved by the Food and Drug Administration performed on a qualified individual (as defined in paragraph (2)) for the purpose of identifying bone mass or detecting bone loss or determining bone quality, and includes a physician’s interpretation of the results of the procedure. “(2) For purposes of this subsection, the term ‘qualified individual’ means an individual who is (in accordance with regulations prescribed by the Secretary)— “(A) an estrogen-deficient woman at clinical risk for osteoporosis; “(B) an individual with vertebral abnormalities; “(C) an individual receiving long-term glucocorticoid steroid therapy; “(D) an individual with primary hyperparathyroidism; or “(E) an individual being monitored to assess the response to or efficacy of an approved osteoporosis drug therapy. “(3) The Secretary shall establish such standards regarding the frequency with which a qualified individual shall be eligible to be provided benefits for bone mass measurement under this title.”. (b) Payment Under Physician Fee Schedule.—Section 1848(j)(3) (42 U.S.C. 1395w–4(j)(3)), as amended by sections 4102, 4103, 4104 and 4105, is amended— (1) by striking “(4) and (14)” and inserting “(4), (14)” and (2) by inserting “and (15)” after “1861(nn)(2))”. (c) Conforming Amendments.—Sections 1864(a), 1902(a)(9)(C), and 1915(a)(1)(B)(ii)(I) (42 U.S.C. 1395aa(a), 1396a(a)(9)(C), and 1396n(a)(1)(B)(ii)(I)) are amended by striking “paragraphs (15) and (16)” each place it appears and inserting “paragraphs (16) and (17)”. (d) Effective Date.—The amendments made by this section shall apply to bone mass measurements performed on or after July 1, 1998.