,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #bjji  ,,in ,,the ,,house ,,of  
,,representatives  ,april #a1 #bjai,ms4 
,clarke of ,new ,york 7for herself and  
,mr4 ,upton7 introduced the following   
bill2 which was referred to the         
,committee on ,energy and ,commerce1 and
 in addition to the ,committee on ,ways 
and ,means1 for a period to be          
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to amend titles ,,xviii and 
,,xix of the ,social ,security ,act to  
provide equal coverage of in vitro      
specific ,ig,e tests and percutaneous   
tests for allergies under the ,medicare 
and ,medicaid programs1 and for other   
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,removing ,barriers 
to ,allergy ,diagnostic ,testing ,act of
 #bjai4  #b4 ,findings ,congress finds  
the following3  7#a7 ,allergies1 when   
not properly diagnosed1 cannot be       

effectively treated4  7#b7 ,allergies to
 food1 inhaled particles1 or other      
sources can cause debilitating and1 in  
some cases1 fatal reactions4  7#c7      
,allergies can substantially compound   
other illnesses1 including asthma1      
emphysema1 and adult obstructive        
pulmonary diseases1 leading to social   
and economic costs for families and our 
,nation's health care system4  7#d7     
,according to clinical guidelines from  
the ,national ,institutes of ,health and
 recommendations from peer-reviewed     
literature1 in vitro specific ,ig,e     
tests and percutaneous tests are        
considered equivalent as confirmatory   
tests in terms of their sensitivity and 
accuracy4  7#e7 ,despite these          
recommendations1 some current ,medicare 
local coverage determinations and       
,medicaid coverage policies deny equal  
access to in vitro specific ,ig,e tests 
and percutaneous tests4  7#f7 ,in vitro 
specific ,ig,e tests and percutaneous   
tests must be equally accessible for    

clinicians and patients to improve      
health outcomes1 reduce system costs1   
and reduce current health care          
disparities caused by the lack of equal 
coverage4  #c4 ,medicaid coverage for   
allergy diagnostic testing services  7a7
 ,in general ,title ,,xix of the ,social
 ,security ,act 7#db ,u4,s4,c4 #acif et 
seq47 is amended-- 7#a7 in section      
#aijb7;a7--  7,a7 in paragraph 7#he71 by
 striking and at the end2  7,b7 in      
paragraph 7#hf71 by striking the period 
at the end and inserting 2 and2 and     
7,c7 by inserting after paragraph 7#hf7 
the following new paragraph3  7#hg7     
provide1 with respect to the provision  
of allergy diagnostic testing services  
7as defined in section #aije7;ee77 under
 the ,state plan1 for equality in the   
treatment of in vitro specific ,ig,e    
tests and percutaneous tests with       
respect to--  7,a7 any medical necessity
 or other coverage requirements         
established for such in vitro specific  
,ig,e and percutaneous tests2  7,b7 any 

frequency limits established for such   
tests2 and  7,c7 any allergen unit      
limits established for such tests4  2   
and  7#b7 in section #aije-- 7,a7 in    
subsection 7r7--  7i7 by redesignating  
paragraph 7#e7 as paragraph 7#f72 and   
7ii7 by inserting after paragraph 7#d7  
the following new paragraph3  7#e7      
,allergy diagnostic testing services 7as
 defined in subsection 7ff774  2 and    
7,b7 by adding at the end the following 
new subsection3  7ff7 ,allergy          
diagnostic testing services defined ,the
 term allergy diagnostic testing        
services means in vitro specific ,ig,e  
tests and percutaneous tests that-- 7#a7
 have been cleared under section        
#eja7k71 classified under section       
#eac7;f77#b71 or approved under section 
#eae of the ,federal ,food1 ,drug1 and  
,cosmetic ,act2 and  7#b7 are provided  
to individuals for the purpose of       
evaluating immunologic response to      
certain antigens4  4  7b7 ,effective    
date  7#a7 ,in general ,subject to      

paragraph 7#b71 the amendments made by  
this section shall apply with respect to
 items and services provided on or after
 ,january #a1 #bjba4  7#b7 ,exception   
for ,state legislation ,in the case of a
 ,state plan under title ,,xix of the   
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 that the ,secretary of   
,health and ,human ,services determines 
requires ,state legislation in order for
 the respective plan to meet any        
requirement imposed by amendments made  
by this section1 the respective plan    
shall not be regarded as failing to     
comply with the requirements of such    
title solely on the basis of its failure
 to meet such an additional requirement 
before the first day of the first       
calendar quarter beginning after the    
close of the first regular session of   
the ,state legislature that begins after
 the date of the enactment of this ,act4
 ,for purposes of the previous sentence1
 in the case of a ,state that has a     
#b-year legislative session1 each year  

of the session shall be considered to be
 a separate regular session of the      
,state legislature4  #d4 ,medicare      
coverage for allergy diagnostic testing 
services  7a7 ,coverage ,section #ahfa  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #aciex7 is amended-- 7#a7 in  
subsection 7s77#b7--  7,a7 in           
subparagraph 7,,gg71 by striking and at 
the end2  7,b7 in subparagraph 7,,hh71  
by striking the period at the end and   
inserting 2 and2 and  7,c7 by adding at 
the end the following new subparagraph3 
7,,ii7 allergy diagnostic testing       
services 7as defined in subsection      
7kkk772  2 and  7#b7 by adding at the   
end the following new subsection3  7kkk7
 ,allergy diagnostic testing services   
7#a7 ,in general ,the term allergy      
diagnostic testing services means in    
vitro specific ,ig,e tests and          
percutaneous tests--  7,a7 that have    
been cleared under section #eja7k71     
classified under section #eac7;f77#b71  
or approved under section #eae of the   

,federal ,food1 ,drug1 and ,cosmetic    
,act2 and  7,b7 which are furnished to  
individuals for the purpose of          
evaluating immunologic response to      
certain antigens1 as determined         
appropriate by the practitioner ordering
 such test4  7#b7 ,equal access to      
testing methods ,the ,secretary shall   
ensure equality in the treatment of in  
vitro specific ,ig,e tests and          
percutaneous tests described in         
paragraph 7#a7 with respect to--  7,a7  
any medical necessity or other coverage 
requirements established for such in    
vitro specific ,ig,e and percutaneous   
tests2  7,b7 any frequency limits       
established for such tests2 and  7,c7   
any allergen unit limits established for
 a year for such tests4  4  7b7 ,payment
 ,section #ahcd of the ,social ,security
 ,act 7#db ,u4,s4,c4 #aciem7 is amended 
by adding at the end the following new  
subsection3  7x7 ,allergy diagnostic    
testing services ,for purposes of       
payment only1 in the case of allergy    

diagnostic testing services 7as defined 
in section #ahfa7;jjj77--  7#a7 in vitro
 specific ,ig,e tests shall be treated  
as clinical diagnostic laboratory tests2
 and  7#b7 percutaneous tests shall be  
treated as physicians' services4  4  7c7
 ,effective date ,the amendments made by
 this section shall apply with respect  
to items and services furnished on or   
after ,january #a1 #bjba4