Page:United States Statutes at Large Volume 104 Part 2.djvu/505

 PUBLIC LAW 101-508 —NOV. 5, 1990 104 STAT. 1388-97 "(13) screening mammography (as defined in subsection (jj));"; and (2) by inserting after subsection (ii) the following new subsection: " Screening Mammography "(jj) The term 'screening mammography' mesins 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 of such Act (42 U.S.C. 1395m) is amended— (1) in subsection (b)(1)(B), by inserting "and subject to subsection (c)(1)(A)" after "conversion factors", and (2) by inserting after subsection (b) the following new subsection: "(c) PAYMENTS AND STANDARDS FOR SCREENING MAMMOGRAPHY. — "(1) IN GENERAL. — Notwithstanding any other provision of this part, with respect to expenses incurred for screening mammography (as defined in section 1861(ij))— "(A) payment may be made only for screening mammography conducted consistent with the frequency permitted under paragraph (2); "(B) payment may be made only if the screening mammography meets the quality standards established under paragraph (3); and "(C) 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) or the fee schedule established under section 1848, whichever is applicable, with respect to both the professional and technical components of the screening mammography, 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. "(ii) Payment may be made under this part for only 1 screening mammography 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— "(I) is at a high risk of developing 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 following the month in which a previous screening mammography was performed, or

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