,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #beej  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #ba1 #bjae ,mrs4 
,mc,morris ,rodg]s introduc$ ! foll[+   
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce1 & 9 addition to !    
,committee on ,ways & ,means1 = a p]iod 
to be subsequ5tly det]m9$ by ! ,speak]1 
9 ea* case = consid]ation ( su*         
provisions z fall )9 ! jurisdiction ( ! 
committee conc]n$  ,a ,,bill  ,to am5d  
title ,,xviii ( ! ,social ,security ,act
 to provide ,m$ic>e paym5t inc5tives to 
transition f traditional x-ray imag+ to 
digital radiography1 & = o!r purposes4  
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,m$ical ,imag+ ,mod]nization ,act (   
#bjae4  #b4 ,m$ic>e paym5t inc5tive = ! 
transition f traditional x-ray imag+ to 
digital radiography & o!r ,m$ic>e imag+ 
paym5t provision  7a7 ,physician fee    
s*$ule  7#a7 ,paym5t inc5tive =         
transition  7,a7 ,9 g5]al ,section      
#ahdh7;b7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciew-#d7;b77 is am5d$  

by add+ at ! end ! foll[+ new p>agraph3 
7#i7 ,special rule to inc5tivize        
transition f traditional x-ray imag+ to 
digital radiography  7,a7 ,limitation on
 paym5t = film x-ray imag+ s]vices ,9 ! 
case ( imag+ s]vices t are ,x-rays tak5 
us+ film & t are furni%$ dur+ #bjag or a
 subsequ5t ye>1 ! paym5t am\nt = !      
te*nical compon5t 7includ+ ! te*nical   
compon5t portion ( a global fee7 ( su*  
s]vices t w\ld o!rwise be det]m9$ "u ?is
 section 7)\t application ( ?is p>agraph
 & be=e application ( any o!r adju/m5t  
"u ?is section7 = su* ye> %all be r$uc$ 
by #bj p]c5t4  7,b7 ,phas$-9 limitation 
on paym5t = comput$ radiography imag+   
s]vices ,9 ! case ( imag+ s]vices t are 
,x-rays tak5 us+ comput$ radiography    
te*nology-- 7i7 9 ! case ( su* s]vices  
furni%$ dur+ #bjah1 #bjai1 #bjbj1 #bjba1
 or #bjbb ! paym5t am\nt = ! te*nical   
compon5t 7includ+ ! te*nical compon5t   
portion ( a global fee7 ( su* s]vices t 
w\ld o!rwise be det]m9$ "u ?is section  
7)\t application ( ?is p>agraph & be=e  

application ( any o!r adju/m5t "u ?is   
section7 = su* ye> %all be r$uc$ by #g  
p]c5t2 &  7ii7 9 ! case ( su* s]vices   
furni%$ dur+ #bjbc or a subsequ5t ye>1 !
 paym5t am\nt = ! te*nical compon5t     
7includ+ ! te*nical compon5t portion ( a
 global fee7 ( su* s]vices t w\ld       
o!rwise be det]m9$ "u ?is section 7)\t  
application ( ?is p>agraph & be=e       
application ( any o!r adju/m5t "u ?is   
section7 = su* ye> %all be r$uc$ by #aj 
p]c5t4  7,c7 ,comput$ radiography       
te*nology def9$ ,= purposes ( ?is       
p>agraph1 ! t]m comput$ radiography     
te*nology means cassette-bas$ imag+ :i* 
utilizes an imag+ plate to create !     
image involv$4  7,d7 ,implem5tation ,9  
ord] to implem5t ?is p>agraph1 !        
,secret>y %all adopt appropriate        
me*anisms :i* may include use (         
modifi]s4  4  7,b7 ,exemption f budget  
neutrality ,section                     
#ahdh7;c77#b77;,b77v7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;c77#b77;,b77v77 is am5d$1 by 

add+ at ! end ! foll[+ new subclause3   
7,x7 ,r$uc$ exp5ditures attributable to 
inc5tives to transition to digital      
radiography ,effective = fee s*$ules    
e/abli%$ beg9n+ ) #bjag1 r$uc$          
exp5ditures attributable to subp>agraph 
7,a7 ( subsection 7b77#i7 & effective = 
fee s*$ules e/abli%$ beg9n+ ) #bjah1    
r$uc$ exp5ditures attributable to       
subp>agraph 7,b7 ( su* subsection4  4   
7#b7 ,elim9ation ( application (        
multiple proc$ure paym5t r$uction       
,section #ahdh7;b77#d7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;b77#d77 is am5d$ by add+ at !
 end ! foll[+ new subp>agraph3  7,e7    
,elim9ation ( application ( multiple    
proc$ure paym5t r$uction  7i7 ,9 g5]al  
,n lat] ?an ,janu>y #a1 #bjaf1 !        
,secret>y %all n apply a multiple       
proc$ure paym5t r$uction policy to !    
pr(essional compon5t ( imag+ s]vices    
furni%$ 9 any subsequ5t ye> t is prior  
to a ye> 9 :i* ! ,secret>y conducts &   
publi%es1 z "p ( ! ,m$ic>e ,physician   

,fee ,s*$ule ,propos$ ,rule = a ye>1 !  
empirical analysis describ$ 9 clause    
7ii74  7ii7 ,empirical analysis describ$
 ,! empirical analysis describ$ 9 ?is   
clause is an analysis ( ! ,res\rce-,bas$
 ,relative ,value ,scale 7commonly kn[n 
z ! ,,rbrvs7 ,data ,manag] in=mation t  
is us$ to det]m9e :at1 if any1          
effici5cies exi/ )9 ! pr(essional       
compon5t ( imag+ s]vices :5 two or m    
/udies are p]=m$ on ! same pati5t on !  
same day4 ,su* empirical analysis %all  
include--  7,i7 "w %eets & o!r in=mation
 detail+ :i* physician "w activities    
p]=m$ giv5 ! typical vignettes 7 assign$
 r$uction p]c5tages ( #j1 #be1 #ej1 #ge 
& #ajj p]c5t2  7,,ii7 a discussion ( !  
cl9ical aspects t in=m$ ! assignm5t ( ! 
r$uction p]c5tages describ$ 9 subclause 
7,i72  7,,iii7 an explanation ( h[ !    
p]c5tage r$uctions = pre-1 intra &      
po/-s]vice "w 7 det]m9$ & calculat$2 &  
7,,iv7 a demon/ration t ! ,c5t]s =      
,m$ic>e  ,m$icaid ,s]vices has consult$ 
) practic+ radiologi/s to ga9 k ( h[    

radiologi/s int]pret /udies ( multiple  
body p>ts on ! same individual on ! same
 day4  4  7b7 ,paym5t inc5tive =        
transition "u hospital outpati5t        
prospective paym5t sy/em ,section       
#ahcc7t77#af7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie7t77#af77 is am5d$ 
by add+ at ! end ! foll[+ new           
subp>agraph3  7,f7 ,paym5t inc5tive = ! 
transition f traditional x-ray imag+ to 
digital radiography ,not)/&+ ! previ\s  
provisions ( ?is subsection3 7i7        
,limitation on paym5t = film x-ray imag+
 s]vices ,9 ! case ( imag+ s]vices t are
 ,x-rays tak5 us+ film & t are furni%$  
dur+ #bjag or a subsequ5t ye>1 ! paym5t 
am\nt = ! te*nical compon5t 7includ+ !  
te*nical compon5t portion ( a global    
fee7 ( su* s]vices t w\ld o!rwise be    
det]m9$ "u ?is section 7)\t application 
( ?is p>agraph & be=e application ( any 
o!r adju/m5t "u ?is subsection7 = su*   
ye> %all be r$uc$ by #bj p]c5t4  7ii7   
,phas$-9 limitation on paym5t = comput$ 
radiography imag+ s]vices ,9 ! case (   

imag+ s]vices t are ,x-rays tak5 us+    
comput$ radiography te*nology 7z def9$ 9
 section #ahdh7;b77#i77;,c77--  7,i7 9 !
 case ( su* s]vices furni%$ dur+ #bjah1 
#bjai1 #bjbj1 #bjba1 or #bjbb ! paym5t  
am\nt = ! te*nical compon5t 7includ+ !  
te*nical compon5t portion ( a global    
fee7 ( su* s]vices t w\ld o!rwise be    
det]m9$ "u ?is section 7)\t application 
( ?is p>agraph & be=e application ( any 
o!r adju/m5t "u ?is subsection7 = su*   
ye> %all be r$uc$ by #g p]c5t2 &  7,,ii7
 9 ! case ( su* s]vices furni%$ dur+    
#bjbc or a subsequ5t ye>1 ! paym5t am\nt
 = ! te*nical compon5t 7includ+ !       
te*nical compon5t portion ( a global    
fee7 ( su* s]vices t w\ld o!rwise be    
det]m9$ "u ?is section 7)\t application 
( ?is p>agraph & be=e application ( any 
o!r adju/m5t "u ?is subsection7 = su*   
ye> %all be r$uc$ by #aj p]c5t4  7iii7  
,application )\t reg>d to budget        
neutrality ,! r$uctions made "u ?is     
p>agraph-- 7,i7 %all n be consid]$ an   
adju/m5t "u p>agraph 7#b77;,e72 &       

7,,ii7 %all n be implem5t$ 9 a budget   
neutral mann]4  4