United States 117th Congress Status: Died 1 D cosponsors

HR 3657 — Medicare Access to Radiology Care Act of 2021

Last action — Referred to the Subcommittee on Health.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. Died in session

This bill died with 117th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Medicare Access to Radiology Care Act of 2021 This bill provides for Medicare coverage of services that are furnished by a certified radiologist assistant under the supervision of a radiologist. Payment must be made to the supervising radiologist.

Bill Text

Sections of law this bill changes

2 sections in 1 law

From the bill's own amending language, matched to the official United States Code (current through Public Law 119-124).

Social security · 42 U.S.C. ch. 7 2 sections
  • § 1395m Special payment rules for particular items and services Amends

    42 U.S.C. § 1395m

    The law today

    (a) Payment for durable medical equipment (1) General rule for payment (A) In general With respect to a covered item (as defined in paragraph (13)) for which payment is determined under this subsection, payment shall be made in the frequency specified in paragraphs (2) through (7) and in an amount equal to 80 percent of the payment basis described in subparagraph (B). (B) Payment basis Subject to subparagraph (F)(i), the payment basis described in this subparagraph is the lesser of— (i) the actual charge for the item, or (ii) the payment amount recognized under paragraphs (2) through (7) of this subsection for the item; except that clause (i) shall not apply if the covered item is furnished by a public home health agency (or by another home health agency which demonstrates to the satisfaction of the Secretary that a significant portion of its patients are low income) free of charge or at nominal charges to the public. (C) Exclusive payment rule Subject to subparagraph (F)(ii), this subsection shall constitute the exclusive provision of this subchapter for payment for covered items under this part or under part A to a home health agency. (D) Reduction in fee schedules for certain items With respect to a seat-lift chair or transcutaneous electrical nerve stimulator furnished on or after April 1, 1990, the Secretary shall reduce the payment amount applied under subparagraph (B)(ii) for such an item by 15 percent, and, in the case of a transcutaneous electrical nerve stimulator furnished on or after January 1, 1991, the Secretary shall further reduce such payment amount (as previously reduced) by 45 percent. (E) Clinical conditions for coverage (i) In general The Secretary shall establish standards for clinical conditions for payment for covered items under this subsection. (ii) Requirements The standards established under clause (i) shall include the specification of types or classes of covered items that require, as a condition of payment under this subsection, a face-to-face examination of the individual by a physician (as defined in section 1395x(r) of this title), a physician assistant, nurse practitioner, or a clinical nurse specialist (as those terms are defined in section 1395x(aa)(5) of this title) and a prescription for the item. (iii) Priority of establishment of standards In establishing the standards under this subparagraph, the Secretary shall first establish standards for those covered items for which the Secretary determines there has been a proliferation of use, consistent findings of charges for covered items that are not delivered, or consistent findings of falsification of documentation to provide for payment of such covered items under this part. (iv) Standards for power wheelchairs Effective on December 8, 2003, in the case of a covered item consisting of a motorized or power wheelchair for an individual, payment may not be made for such covered item unless a physician (as defined in section 1395x(r)(1) of this title), a physician assistant, nurse practitioner, or a clinical nurse specialist (as those terms are defined in section 1395x(aa)(5) of this title) has conducted a face-to-face examination of the individual and written a prescription for the item. (v) Limitation on payment for covered items Payment may not be made for a covered item under this subsection unless the item meets any standards established under this subparagraph for clinical condition of coverage. (F) Application of competitive acquisition; limitation of inherent reasonableness authority In the case of covered items furnished on or after January 1, 2011, subject to subparagraphs (G) and (H), that are included in a competitive acquisition program in a competitive acquisition area under section 1395w–3(a) of this title— (i) the payment basis under this subsection for such items and services furnished in such area shall be the payment basis determined under such competitive acquisition program; (ii) the Secretary may (and, in the case of ...

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  • § 1395u Provisions relating to the administration of part B Amends

    42 U.S.C. § 1395u — at 1395u(b)(6)

    The law today

    (a) In general The administration of this part shall be conducted through contracts with medicare administrative contractors under section 1395kk–1 of this title. (b) Determination of reasonable charges (1) Repealed. Pub. L. 108–173, title IX, § 911(c)(3)(A), Dec. 8, 2003, 117 Stat. 2384. (2) (A) , (B) Repealed. Pub. L. 108–173, title IX, § 911(c)(3)(B)(i), Dec. 8, 2003, 117 Stat. 2384. (C) In the case of residents of nursing facilities who receive services described in clause (i) or (ii) of section 1395x(s)(2)(K) of this title performed by a member of a team, the Secretary shall instruct medicare administrative contractors to develop mechanisms which permit routine payment under this part for up to 1.5 visits per month per resident. In the previous sentence, the term “team” refers to a physician and includes a physician assistant acting under the supervision of the physician or a nurse practitioner working in collaboration with that physician, or both. (3) The Secretary— (A) shall take such action as may be necessary to assure that, where payment under this part for a service is on a cost basis, the cost is reasonable cost (as determined under section 1395x(v) of this title); (B) shall take such action as may be necessary to assure that, where payment under this part for a service is on a charge basis, such charge will be reasonable and not higher than the charge applicable, for a comparable service and under comparable circumstances, to the policyholders and subscribers of the medicare administrative contractor, and such payment will (except as otherwise provided in section 1395gg(f) of this title) be made— (i) on the basis of an itemized bill; or (ii) on the basis of an assignment under the terms of which (I) the reasonable charge is the full charge for the service, (II) the physician or other person furnishing such service agrees not to charge (and to refund amounts already collected) for services for which payment under this subchapter is denied under section 1320c–3(a)(2) of this title by reason of a determination under section 1320c–3(a)(1)(B) of this title, and (III) the physician or other person furnishing such service agrees not to charge (and to refund amounts already collected) for such service if payment may not be made therefor by reason of the provisions of paragraph (1) of section 1395y(a) of this title, and if the individual to whom such service was furnished was without fault in incurring the expenses of such service, and if the Secretary’s determination that payment (pursuant to such assignment) was incorrect and was made subsequent to the third year following the year in which notice of such payment was sent to such individual; except that the Secretary may reduce such three-year period to not less than one year if he finds such reduction is consistent with the objectives of this subchapter (except in the case of physicians’ services and ambulance service furnished as described in section 1395y(a)(4) of this title, other than for purposes of section 1395gg(f) of this title); but (in the case of bills submitted, or requests for payment made, after March 1968) only if the bill is submitted, or a written request for payment is made in such other form as may be permitted under regulations, no later than the period ending 1 calendar year after the date of service; (C) to (E) Repealed. Pub. L. 108–173, title IX, § 911(c)(3)(C)(iv), Dec. 8, 2003, 117 Stat. 2384; (F) shall take such action as may be necessary to assure that where payment under this part for a service rendered is on a charge basis, such payment shall be determined on the basis of the charge that is determined in accordance with this section on the basis of customary and prevailing charge levels in effect at the time the service was rendered or, in the case of services rendered more than 12 months before the year in which the bill is submitted or request for payment is made, on the basis of such levels in effect for the 12-month period preceding s...

    84 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

How this bill changes current law

7 changes Share ↗

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

This bill introduces payment provisions for radiologist assistant services under the Medicare program.

  • 42 U.S.C. 1395m

    (z) Payment for Certain Radiologist Assistant Services.--

    This adds a new subsection for payment of radiologist assistant services.

  • 42 U.S.C. 1395m

    (1) Payment.--(A) In general.--In the case of radiologist assistant services (as defined in subparagraph (B)) furnished on or after January 1, 2021, for which payment is made under the fee schedules established under section 1848, the amount of payment for such services shall equal 85 percent of the amount determined under section 1848 for such services when furnished by a radiologist.

    Establishes payment rates for radiologist assistant services at 85% of what a radiologist would receive.

  • 42 U.S.C. 1395m

    (B) Definitions.--In this subsection: (i) Radiologist assistant services.--The term `radiologist assistant services' means services furnished as an incident to a radiologists' professional service-- (I) performed by a radiologist assistant (as defined in clause (ii)) under the supervision of a radiologist as an employee of, a leased employee of, or an independent contractor of the supervising radiologist; and (II) which the radiologist assistant is legally authorized to perform under State law (or the State regulatory mechanism provided by State law). (ii) Radiologist assistant.--The term `radiologist assistant' means a radiographer who is certified by the American Registry of Radiologic Technologists as a registered radiologist assistant or by the Certification Board for Radiology Practitioner Assistants as a radiology practitioner assistant to perform radiologic procedures under the supervision of a radiologist.

    Defines what constitutes radiologist assistant services and identifies who qualifies as a radiologist assistant.

  • 42 U.S.C. 1395m

    (2) Payment in facility settings.--(A) In general.--The Secretary shall provide for payment for radiologist assistant services in a facility setting furnished on or after January 1, 2022. Payment shall be made to the supervising radiologist.

    Provides a framework for payment for radiologist assistant services in facility settings starting January 1, 2022.

  • 42 U.S.C. 1395m

    (B) Payment amount.--The amount of payment for radiologist assistant services furnished in a facility setting shall be the amount determined under paragraph (1).

    Establishes that the payment amount for services in facility settings corresponds to the previously defined rates.

  • 42 U.S.C. 1395m

    (C) Facility setting defined.--In this paragraph, the term `facility setting' means-- (i) a hospital or critical access hospital; (ii) an ambulatory surgical center; and (iii) such other providers of services as the Secretary may specify.

    Defines what qualifies as a facility setting for the provision of radiologist assistant services.

  • 42 U.S.C. 1395u(b)(6)

    and → and (K) in the case of radiologist assistant services (as defined in section 1834(z)(1)(B)(i)), payment shall be made to the supervising radiologist

    Clarifies that payment for radiologist assistant services should be directed to the supervising radiologist.

Action History

  1. Referred to the Subcommittee on Health.

  2. Introduced in House

  3. Introduced in House

  4. Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  5. Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  6. Referred to the Subcommittee on Health.

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 546 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (546)

546 members have not signed on to this bill.

Show all 546 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
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Frequently asked questions

What does HR 3657 do?
Medicare Access to Radiology Care Act of 2021 This bill provides for Medicare coverage of services that are furnished by a certified radiologist assistant under the supervision of a radiologist. Payment must be made to the supervising radiologist.
Who sponsors HR 3657?
HR 3657 is sponsored by Doyle, Michael F. (Democratic).
What is the current status of HR 3657?
This bill died with 117th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HR 3657?
Track HR 3657 free on One Click Politics — get push/email alerts when it moves.

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