United States 115th Congress Status: Died Bipartisan · 50 D · 40 R cosponsors

HR 1298 — CT Colonography Screening for Colorectal Cancer Act of 2017

Last action — Referred to the Subcommittee on Health.

Track this bill free

No card. One bill, free forever — alerts when it moves.

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

This bill died with 115th 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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

CT Colonography Screening for Colorectal Cancer Act of 2017 This bill amends title XVIII (Medicare) of the Social Security Act to: (1) provide Medicare coverage for screening computed tomography colonography (CTC) as a colorectal cancer screening test, and (2) exclude screening CTC from a special Medicare payment rule applicable to certain imaging services.

Bill Text

Sections of law this bill changes

3 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 3 sections
  • § 1395m Special payment rules for particular items and services Amends

    42 U.S.C. § 1395m — at 1395m(d)

    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 ...

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

  • § 1395w-4 Payment for physicians’ services Amends

    42 U.S.C. § 1395w-4 — at 1395w-4(b)(4)(B)

    The law today

    (a) Payment based on fee schedule (1) In general Effective for all physicians’ services (as defined in subsection (j)(3)) furnished under this part during a year (beginning with 1992) for which payment is otherwise made on the basis of a reasonable charge or on the basis of a fee schedule under section 1395m(b) of this title, payment under this part shall instead be based on the lesser of— (A) the actual charge for the service, or (B) subject to the succeeding provisions of this subsection, the amount determined under the fee schedule established under subsection (b) for services furnished during that year (in this subsection referred to as the “fee schedule amount”). (2) Transition to full fee schedule (A) Limiting reductions and increases to 15 percent in 1992 (i) Limit on increase In the case of a service in a fee schedule area (as defined in subsection (j)(2)) for which the adjusted historical payment basis (as defined in subparagraph (D)) is less than 85 percent of the fee schedule amount for services furnished in 1992, there shall be substituted for the fee schedule amount an amount equal to the adjusted historical payment basis plus 15 percent of the fee schedule amount otherwise established (without regard to this paragraph). (ii) Limit in reduction In the case of a service in a fee schedule area for which the adjusted historical payment basis exceeds 115 percent of the fee schedule amount for services furnished in 1992, there shall be substituted for the fee schedule amount an amount equal to the adjusted historical payment basis minus 15 percent of the fee schedule amount otherwise established (without regard to this paragraph). (B) Special rule for 1993, 1994, and 1995 If a physicians’ service in a fee schedule area is subject to the provisions of subparagraph (A) in 1992, for physicians’ services furnished in the area— (i) during 1993, there shall be substituted for the fee schedule amount an amount equal to the sum of— (I) 75 percent of the fee schedule amount determined under subparagraph (A), adjusted by the update established under subsection (d)(3) for 1993, and (II) 25 percent of the fee schedule amount determined under paragraph (1) for 1993 without regard to this paragraph; (ii) during 1994, there shall be substituted for the fee schedule amount an amount equal to the sum of— (I) 67 percent of the fee schedule amount determined under clause (i), adjusted by the update established under subsection (d)(3) for 1994 and as adjusted under subsection (c)(2)(F)(ii) and under section 13515(b) of the Omnibus Budget Reconciliation Act of 1993, and (II) 33 percent of the fee schedule amount determined under paragraph (1) for 1994 without regard to this paragraph; and (iii) during 1995, there shall be substituted for the fee schedule amount an amount equal to the sum of— (I) 50 percent of the fee schedule amount determined under clause (ii) adjusted by the update established under subsection (d)(3) for 1995, and (II) 50 percent of the fee schedule amount determined under paragraph (1) for 1995 without regard to this paragraph. (C) Special rule for anesthesia and radiology services With respect to physicians’ services which are anesthesia services, the Secretary shall provide for a transition in the same manner as a transition is provided for other services under subparagraph (B). With respect to radiology services, “109 percent” and “9 percent” shall be substituted for “115 percent” and “15 percent”, respectively, in subparagraph (A)(ii). (D) “Adjusted historical payment basis” defined (i) In general In this paragraph, the term “adjusted historical payment basis” means, with respect to a physicians’ service furnished in a fee schedule area, the weighted average prevailing charge applied in the area for the service in 1991 (as determined by the Secretary without regard to physician specialty and as adjusted to reflect payments for services with customary charges below the prevailing charge or other payment limitation...

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

  • § 1395x Definitions Amends

    42 U.S.C. § 1395x — at 1395x(pp)(1)

    The law today

    For purposes of this subchapter— (a) Spell of illness The term “spell of illness” with respect to any individual means a period of consecutive days— (1) beginning with the first day (not included in a previous spell of illness) (A) on which such individual is furnished inpatient hospital services, inpatient critical access hospital services or extended care services, and (B) which occurs in a month for which he is entitled to benefits under part A, and (2) ending with the close of the first period of 60 consecutive days thereafter on each of which he is neither an inpatient of a hospital or critical access hospital nor an inpatient of a facility described in section 1395i–3(a)(1) of this title or subsection (y)(1). (b) Inpatient hospital services The term “inpatient hospital services” means the following items and services furnished to an inpatient of a hospital and (except as provided in paragraph (3)) by the hospital— (1) bed and board; (2) such nursing services and other related services, such use of hospital facilities, and such medical social services as are ordinarily furnished by the hospital for the care and treatment of inpatients, and such drugs, biologicals, supplies, appliances, and equipment, for use in the hospital, as are ordinarily furnished by such hospital for the care and treatment of inpatients; and (3) such other diagnostic or therapeutic items or services, furnished by the hospital or by others under arrangements with them made by the hospital, as are ordinarily furnished to inpatients either by such hospital or by others under such arrangements; excluding, however— (4) medical or surgical services provided by a physician, resident, or intern, services described by subsection (s)(2)(K), certified nurse-midwife services, qualified psychologist services, and services of a certified registered nurse anesthetist; and (5) the services of a private-duty nurse or other private-duty attendant. Paragraph (4) shall not apply to services provided in a hospital by— (6) an intern or a resident-in-training under a teaching program approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association, or, in the case of services in a hospital or osteopathic hospital by an intern or resident-in-training in the field of dentistry, approved by the Council on Dental Education of the American Dental Association, or in the case of services in a hospital or osteopathic hospital by an intern or resident-in-training in the field of podiatry, approved by the Council on Podiatric Medical Education of the American Podiatric Medical Association; or (7) a physician where the hospital has a teaching program approved as specified in paragraph (6), if (A) the hospital elects to receive any payment due under this subchapter for reasonable costs of such services, and (B) all physicians in such hospital agree not to bill charges for professional services rendered in such hospital to individuals covered under the insurance program established by this subchapter. (c) Inpatient psychiatric hospital services The term “inpatient psychiatric hospital services” means inpatient hospital services furnished to an inpatient of a psychiatric hospital. (d) Supplier The term “supplier” means, unless the context otherwise requires, a physician or other practitioner, a facility, or other entity (other than a provider of services) that furnishes items or services under this subchapter. (e) Hospital The term “hospital” (except for purposes of sections 1395f(d), 1395f(f), and 1395n(b) of this title, subsection (a)(2) of this section, paragraph (7) of this subsection, and subsection (i) of this section) means an institution which— (1) is primarily engaged in providing, by or under the supervision of physicians, to inpatients (A) diagnostic services and therapeutic services for medical ...

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

How this bill changes current law

4 changes Share ↗

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

The bill adds coverage for screening computed tomography colonography as a colorectal cancer screening test under Medicare.

  • 42 U.S.C. 1395x(pp)(1)

    (D) Screening computed tomography colonography.

    Inserts a new type of screening test for colorectal cancer into the list of covered items.

  • 42 U.S.C. 1395m(d)

    (4) Screening computed tomography colonography.--(A) Fee schedule.--With respect to a colorectal cancer screening test consisting of screening computed tomography colonography, subject to subparagraph (B), payment under section 1848 shall be consistent with payment under such section for similar or related services. (B) Payment limit.--In the case of screening computed tomography colonography, payment under this part shall not exceed such amount as the Secretary specifies, based upon rates recognized for diagnostic computed tomography colonography. (C) Facility payment limit.--Notwithstanding any other provision of this title, in the case of an individual who receives screening computed tomography colonography-- (i) in computing the amount of any applicable coinsurance, the computation of such coinsurance shall be based upon the fee schedule under which payment is made for the services; and (ii) the amount of such coinsurance shall not exceed 25 percent of the payment amount under the fee schedule described in subparagraph (A). (D) Frequency limit.--No payment may be made under this part for a colorectal cancer screening test consisting of a screening computed tomography colonography-- (i) if the individual is under 50 years of age; or (ii)(I) in the case of individuals at high risk for colorectal cancer, if the procedure is performed within the 23 months after a previous screening computed tomography colonography or a previous screening colonoscopy; or (II) in the case of an individual who is not at high risk for colorectal cancer, if the procedure is performed within the 119 months after a previous screening colonoscopy or within the 59 months after a previous screening flexible sigmoidoscopy or a previous screening computed tomography colonography.

    Adds new payment and frequency limits for screening computed tomography colonography under Medicare.

  • 42 U.S.C. 1395m(d)

    and screening computed tomography colonography

    Updates frequency limits for existing colorectal cancer screening tests to include screening computed tomography colonography.

  • 42 U.S.C. 1395w-4(b)(4)(B)

    and screening computed tomography colonography

    Exempts screening computed tomography colonography from special payment rules applicable to imaging services.

Action History

  1. Referred to the Subcommittee on Health.

  2. Referred to the Subcommittee on Health.

  3. Introduced in House

  4. Introduced in House

  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 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.

  7. 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.

Sponsors

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 89 co-sponsors · 457 not signed on

Sponsors (1)

Co-sponsors (89)

Not signed on (457)

457 members have not signed on to this bill.

Show all 457 →

"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
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HR 1298 do?
CT Colonography Screening for Colorectal Cancer Act of 2017 This bill amends title XVIII (Medicare) of the Social Security Act to: (1) provide Medicare coverage for screening computed tomography colonography (CTC) as a colorectal cancer screening test, and (2) exclude screening CTC from a special Medicare payment rule applicable to certain imaging services.
Who sponsors HR 1298?
HR 1298 is sponsored by Wenstrup, Brad R. (Republican), Davis, Danny K. (Democratic), Barr, Andy (Republican), Pittenger, Robert (Republican), Harris, Andy (Republican), McGovern, James P. (Democratic), Grothman, Glenn (Republican), Scott, David (Democratic), Stivers, Steve (Republican), Lewis, John (Democratic), Kelly, Mike (Republican), Walorski, Jackie (Republican), Napolitano, Grace F. (Democratic), Cohen, Steve (Democratic), Ruppersberger, C. A. Dutch (Democratic), Ros-Lehtinen, Ileana (Republican), Rouzer, David (Republican), Loebsack, David (Democratic), Rosen, Jacky (Democratic), Marshall, Roger (Republican), Moulton, Seth (Democratic), Amodei, Mark E. (Republican), Brady, Robert A. (Democratic), Crawford, Eric A. "Rick" (Republican), Chu, Judy (Democratic), Carter, Earl L. "Buddy" (Republican), Rogers, Mike D. (Republican), McCollum, Betty (Democratic), Schneider, Bradley Scott (Democratic), Heck, Denny (Democratic), Sewell, Terri A. (Democratic), Mooney, Alexander X. (Republican), Walz, Timothy J. (Democratic), Emmer, Tom (Republican), Flores, Bill (Republican), Herrera Beutler, Jaime (Republican), LaHood, Darin (Republican), McKinley, David B. (Republican), Welch, Peter (Democratic), Yoder, Kevin (Republican), Katko, John (Republican), Carbajal, Salud O. (Democratic), Boyle, Brendan F. (Democratic), Stefanik, Elise M. (Republican), Clarke, Yvette D. (Democratic), Pingree, Chellie (Democratic), Kuster, Ann M. (Democratic), Higgins, Brian (Democratic), Langevin, James R. (Democratic), Kennedy, Joseph P., III (Democratic), Meng, Grace (Democratic), Maloney, Sean Patrick (Democratic), Tonko, Paul (Democratic), Doyle, Michael F. (Democratic), Schiff, Adam B. (Democratic), Brooks, Mo (Republican), Brownley, Julia (Democratic), Hanabusa, Colleen (Democratic), Wasserman Schultz, Debbie (Democratic), Davis, Rodney (Republican), Evans, Dwight (Democratic), Gibbs, Bob (Republican), Raskin, Jamie (Democratic), Denham, Jeff (Republican), Allen, Rick W. (Republican), Valadao, David G. (Republican), Engel, Eliot L. (Democratic), Capuano, Michael E. (Democratic), Adams, Alma S. (Democratic), Grijalva, Raúl M. (Democratic), Reed, Tom (Republican), Johnson, Mike (Republican), DeSaulnier, Mark (Democratic), Coffman, Mike (Republican), Clark, Katherine M. (Democratic), Watson Coleman, Bonnie (Democratic), Latta, Robert E. (Republican), Byrne, Bradley (Republican), Renacci, James B. (Republican), Peters, Scott H. (Democratic), Ferguson, A. Drew (Republican), McEachin, A. Donald (Democratic), Loudermilk, Barry (Republican), Lynch, Stephen F. (Democratic), Roe, David P. (Republican), Sherman, Brad (Democratic), Tsongas, Niki (Democratic), Aguilar, Pete (Democratic), Kildee, Daniel T. (Democratic), and Tipton, Scott R. (Republican).
What is the current status of HR 1298?
This bill died with 115th 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 1298?
Track HR 1298 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on HR 1298

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of HR 1298

Last checked for changes 3 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →