,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #bfic  ,,in ,,the ,,house ,,of  
,,representatives  ,may #ad1 #bjai,mr4  
,larson of ,connecticut 7for himself1   
,ms4 ,snchez1 ,mrs4 ,walorski1 ,mrs4    
,brooks of ,indiana1 ,mrs4 ,trahan1 ,mr4
 ,marshall1 ,mr4 ,byrne1 ,ms4 ,clarke of
 ,new ,york1 ,mr4 ,courtney1 ,mr4       
,rodney ,davis of ,illinois1 ,mrs4      
,dingell1 ,mr4 ,fitzpatrick1 ,mr4       
,hastings1 ,ms4 ,johnson of ,texas1 ,mr4
 ,kelly of ,pennsylvania1 ,mr4 ,king of 
,new ,york1 ,mrs4 ,carolyn ,b4 ,maloney 
of ,new ,york1 and ,mr4 ,david ,p4 ,roe 
of ,tennessee7 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 title ,,xviii of   
the ,social ,security ,act to improve   

access to1 and utilization of1 bone mass
 measurement benefits under part ,b of  
the ,medicare program by establishing a 
minimum payment amount under such part  
for bone mass measurement4  #a4         
,findings ,the ,congress finds the      
following3 7#a7 ,osteoporosis is a major
 public health problem with #ed million 
,americans as of #bjaj having either low
 bone mass or osteoporosis1 responsible 
for over #b million fractures per year1 
including over #cjj1jjj hip fractures4  
,the estimated total cost of these      
fractures is expected to rise to over   
#be billion by #bjbe4  7#b7             
,osteoporosis is a silent disease that  
often is not discovered until a fracture
 occurs4 ,one out of two women and up to
 one of four men will suffer an         
osteoporotic fracture in their          
lifetimes4  7#c7 ,osteoporosis          
disproportionately impacts women1 who   
account for #ga percent of osteoporotic 
fractures1 and #ge percent of costs4    
7#d7 ,most women are not aware of their 

personal risk factors for osteoporosis1 
the prevalence of1 or the morbidity and 
mortality associated with the disease1  
despite the fact that broken bones due  
to osteoporosis lead to more            
hospitalizations and greater health care
 costs than heart attack1 stroke1 or    
breast cancer in women age #ee and      
above4  7#e7 ,a woman's risk of hip     
fracture is equal to her combined risk  
of breast1 uterine1 and ovarian cancer4 
,more women die in the ,united ,states  
in the year following a hip fracture    
than from breast cancer4  7#f7 ,one out 
of four people who have an osteoporotic 
hip fracture will need long-term nursing
 home care4 ,half of those who          
experience osteoporotic hip fractures   
are unable to walk without assistance4  
7#g7 ,approximately #be percent of women
 over the age of #ej who sustain a hip  
fracture die in the year following the  
fracture1 while a further #bj percent   
will never leave a nursing facility4    
7#h7 ,bone density testing is more      

powerful in predicting fractures than   
cholesterol is in predicting myocardial 
infarction or blood pressure in         
predicting stroke4  7#i7 ,osteoporosis  
remains both under-recognized and       
under-treated4 ,over a #g-year period   
7#bjjg-bjac71 #de percent of older      
female ,medicare beneficiaries had no   
,,dxa bone density test1 and #be percent
 had only one test4  7#aj7 ,since #bjjg1
 ,medicare has cut ,,dxa reimbursement  
by over #gj percent4 ,by #bjaf1 the     
payment cuts caused a loss of #cf       
percent of ,,dxa providers1 resulting in
 a #ba percent decline in osteoporosis  
diagnosis and treatment4  7#aa7 ,a      
decade of steady decline in hip         
fractures stopped abruptly in #bjac4    
,since then1 there have been more than  
#bd1jjj additional hip fractures1       
costing over #a billion1 leading to     
#d1hjj more deaths than expected if the 
decline had continued4  #b4 ,increasing 
access to osteoporosis prevention and   
treatment ,section #ahdh7;b7 of the     

,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;b77 is amended-- 7#a7 in     
paragraph 7#d77;,b7--  7,a7 by striking 
and the first #b months of #bjab and    
inserting the first #b months of #bjab1 
#bjai1 and each subsequent year2 and    
7,b7 by striking paragraph 7#f7 and     
inserting paragraphs 7#f7 and 7#ab72 and
  7#b7 by adding at the end the         
following3  7#ab7 ,establishing minimum 
payment for osteoporosis tests ,for     
dual-energy x-ray absorptiometry        
services 7identified by ,,hcpcs codes   
#ggjhj and #ggjhb and successor codes   
#ggjhe and #ggjhf 7and any succeeding   
codes77 furnished during #bjai or a     
subsequent year1 the ,secretary shall   
establish a national minimum payment    
amount under this subsection--  7,a7 for
 such services identified by ,,hcpcs    
code #ggjhj1 equal to #ih 7with national
 minimum payment amounts of #hg4aa for  
the technical component and #aj4hi for  
the professional component72  7,b7 for  
such services identified by ,,hcpcs code

 #ggjhf1 equal to #ce 7with national    
minimum payment amounts of #bg4ah for   
the technical component and #g4hb for   
the professional component72 and  7,c7  
for the bundled code for dual energy    
absorptiometry and vertebral fracture   
assessment studies identified as ,,hcpcs
 code #ggjhe1 equal to #acc 7with       
national minimum payment amounts of     
#aad4bi for the technical component and 
#ah4ga for the professional component74 
,such minimum payment amounts shall be  
adjusted by the geographical adjustment 
factor established under subsection     
7e77#b7 for the services for the        
respective year4  4