Pub. L. 116-260, div. CC, tit. I, subtit. B, sec. 122 (as amended)

WAIVING MEDICARE COINSURANCE FOR CERTAIN COLORECTAL CANCER SCREENING TESTS.

Year: 2026Length: 391 wordsOfficial source
SEC. 122. WAIVING MEDICARE COINSURANCE FOR CERTAIN COLORECTAL CANCER SCREENING TESTS. (a) In General.—Section 1833(a) of the Social Security Act (42 U.S.C. 1395l(a)) is amended— (1) in the second sentence, by striking “section 1834(0)” and inserting “section 1834(o)”; (2) by moving such second sentence 2 ems to the left; and (3) by inserting the following third sentence following such second sentence: “For services furnished on or after January 1, 2022, paragraph (1)(Y) shall apply with respect to a colorectal cancer screening test regardless of the code that is billed for the establishment of a diagnosis as a result of the test, or for the removal of tissue or other matter or other procedure that is furnished in connection with, as a result of, and in the same clinical encounter as the screening test.”. (b) Special Coinsurance Rule for Certain Tests.—Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended— (1) in subsection (a)(1)(Y), by inserting “subject to subsection (dd),” before “with respect to”; and (2) by adding at the end the following new subsection: “(dd) Special Coinsurance Rule for Certain Colorectal Cancer Screening Tests.— “(1) In general.—In the case of a colorectal cancer screening test to which paragraph (1)(Y) of subsection (a) would not apply but for the third sentence of such subsection that is furnished during a year beginning on or after January 1, 2022, and before January 1, 2030, the amount paid shall be equal to the specified percent (as defined in paragraph (2)) for such year of the lesser of the actual charge for the service or the amount determined under the fee schedule that applies to such test under this part (or, in the case such test is a covered OPD service (as defined in subsection (t)(1)(B)), the amount determined under subsection (t)). “(2) Specified percent defined.—For purposes of paragraph (1), the term ‘specified percent’ means— “(A) for 2022, 80 percent; “(B) for 2023 through 2026, 85 percent; and “(C) for 2027 through 2029, 90 percent.” . (c) Conforming Amendments.—Paragraphs (2) and (3) of section 1834(d) of the Social Security Act (42 U.S.C. 1395m(d)) are each amended— (1) in subparagraph (C)(ii), in the matter preceding subclause (I), by striking “Notwithstanding” and inserting “Subject to section 1833(a)(1)(Y), but notwithstanding”; and (2) in subparagraph (D), by striking “If during” and inserting “Subject to section 1833(a)(1)(Y), if during”.
Pub. L. 116-260, div. CC, tit. I, subtit. B, sec. 122 (as amended): WAIVING MEDICARE COINSURANCE FOR CERTAIN COLORECTAL CANCER SCREENING TESTS. | Justis AI