,,ii  #aaeth ,,congress  #ast ,session  
,s4 #bjfg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #b1  
#bjag,mr4 ,crapo introduced the         
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to provide   
for coverage under the ,medicare program
 of certain ,,dna ,specimen ,provenance 
,assay clinical diagnostic laboratory   
tests4  #a4 ,short title ,this ,act may 
be cited as the ,prostate ,cancer       
,misdiagnosis ,elimination ,act of      
#bjag4  #b4 ,coverage of certain ,,dna  
,specimen ,provenance ,assay clinical   
diagnostic laboratory tests under       
,medicare  7a7 ,coverage ,section       
#ahfb7;a77#a7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #aciey7a77#a77 is   
amended--  7#a7 in subparagraph 7,o71 by
 striking and at the end2  7#b7 in      
subparagraph 7,p71 by striking the      
semicolon at the end and inserting 1    
and2 and  7#c7 by adding at the end the 

following new subparagraph3  7,q7 in the
 case of a ,,dna ,specimen ,provenance  
,assay clinical diagnostic laboratory   
test 7,,dspa test7 furnished on or after
 the date specified in section          
#ahcd;,a7j77#d71 unless the ,,dspa test 
is furnished to an individual enrolled  
under part ,b who has had a prostate    
cancer biopsy the results of which are  
positive1 the ,,dspa test is furnished  
with respect to such biopsy1 and the    
,,dspa test is ordered by the physician 
who furnished the prostate cancer biopsy
 that obtained the specimen tested2  4  
7b7 ,temporary payment amount for       
certain tests furnished before #bjbh and
 related requirements ,section #ahcd;,a 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #aciem-#a7 is amended-- 7#a7  
in subsection 7b77#a77;,a71 by striking 
and 7d7 and inserting 1 7d71 and 7j72   
and  7#b7 by adding at the end the      
following new subsection3  7j7 ,,dna    
,specimen ,provenance ,assay clinical   
diagnostic laboratory tests  7#a7       

,temporary payment amount for certain   
tests furnished before #bjbh ,with      
respect to a ,,dna ,specimen ,provenance
 ,assay clinical diagnostic laboratory  
test furnished on or after the date     
specified in paragraph 7#d7 and before  
,january #a1 #bjbh1 the payment amount  
under this section for such test shall  
be equal to #bjj4  7#b7 ,,hcpcs code and
 modifier assignment  7,a7 ,in general  
,the ,secretary shall assign one or more
 ,,hcpcs codes to the ,,dna ,specimen   
,provenance ,assay clinical diagnostic  
laboratory test and may use a modifier  
to facilitate making payment under this 
section with respect to such test4  7,b7
 ,identification of ,,dna match on claim
 ,the ,secretary shall require an       
indication on a claim for a ,,dna       
,specimen ,provenance ,assay clinical   
diagnostic laboratory test of whether   
the ,,dna of the prostate biopsy        
specimen for such test matches the ,,dna
 of the individual with respect to whom 
the test was ordered4 ,such indication  

may be made through use of a ,,hcpcs    
code1 a modifier1 or other means1 as    
determined appropriate by the           
,secretary4  7#c7 ,,dna match review    
7,a7 ,in general ,the ,secretary shall  
review at least three years of claims   
under part ,b for ,,dna ,specimen       
,provenance ,assay clinical diagnostic  
laboratory tests to identify whether the
 ,,dna of the prostate biopsy specimens 
for such tests matched the ,,dna of the 
individuals with respect to whom such   
tests were ordered4  7,b7 ,posting on   
,internet website ,not later than ,july 
#a1 #bjbd1 the ,secretary shall post on 
the ,internet website of the ,centers   
for ,medicare  ,medicaid ,services the  
findings of the review conducted under  
subparagraph 7,a74  7#d7 ,date specified
 ,for purposes of paragraph 7#a7 and    
section #ahfb7;a77#a77,q71 the date     
specified in this paragraph is the first
 day of the second calendar quarter that
 begins at least #ahj days after the    
date of the enactment of this           

subsection4  4