Page:United States Statutes at Large Volume 102 Part 1.djvu/764

 102 STAT. 726

PUBLIC LAW 100-360—JULY 1, 1988 ''Screening Mammography

"(kk) The term 'screening mammography* means a radiologic procedure provided to a woman for the purpose of early detection of breast cancer and includes a physician's interpretation of the results of the procedure.". (b) PAYMENT AND COVERAGE.—Section 1834 (42 U.S.C. 1395m), as amended by sections 202(b)(4) and 203(c)(l)(F) of this Act, is amended— (1) in subsection OiXlXB), by inserting "and subject to subsection (e)(l)(A)" after "conversion factors", and (2) by adding at the end the following new subsection: "(e) PAYMENTS AND STANDARDS FOR SCREENING MAMMOGRAPHY.—

"(1) IN GENERAL.—Notwithstanding any other provision of this part (except as provided in section 1833(c)), with respect to expenses incurred for screening mammography (as defined in section 1861(kk))— "(A) payment may be made only for screening mammc^raphy conducted consistent with the frequen^'^ permit^ under paragraph (2); "(B) payment may be made only if the screening mammography meets the quality stendards established under paragraph (3); and "(Q the amount of the payment under this part shall, subject to the deductible established under section 1833(b), be equal to 80 percent of the least of— "(i) the actual charge for the screening, "(ii) the fee schedule established under subsection (b) with respect to both the professional and technic^ components of the screening mammc^aphy, in the case of screening mammography subject to such schedule but for this paragraph, or "(iii) the limit established under paragraph (4) for the screening mammography. "(2) FREQUENCY COVERED.—

"(A) IN GENERAL.—Subject to revision by the Secretary under subparagraph (B)— "(i) No payment may be made under this part for screening mammography performed on a woman under 35 years of age. screening mammc^p-aphy performed on a woman over 34 years of age, but under 40 years of age. "(iii) In the case of a woman over 39 years of age, but under 50 years of age, who— "(1) is at a high risk of developii^ breast cancer (as determined pursuant to factors identified by the Secretary), payment may not be made under this part for a screening mammography performed within the 11 months of a previous screening manmu^raphy, or "(Q) is not at a high risk of developing breast cancer, payment may not be made under this part for a screening manmi<^raphy performed within the 23 months after a previous screening mammography.
 * (ii) Payment may be made under this part for only 1

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