Page:United States Statutes at Large Volume 111 Part 1.djvu/387

 PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 363 "(B) Screening flexible sigmoidoscopy. "(C) In the case of an individual at high risk for colorectal cancer, screening colonoscopy. "(D) Such other tests or procedures, and modifications to tests and procedures under this subsection, with such frequency and payment limits, as the Secretary determines appropriate, in consultation with appropriate organizations. "(2) In paragraph (1)(C), an 'individual at high risk for colorectal cancer' is an individual who, because of family history, prior experience of cancer or precursor neoplastic polyps, a history of chronic digestive disease condition (including inflammatory bowel disease, Crohn's Disease, or ulcerative colitis), the presence of any appropriate recognized gene markers for colorectal cancer, or other predisposing factors, faces a high risk for colorectal cancer.". (2) DEADLINE FOR PUBLICATION OF DETERMINATION ON GOV- Federal Register, ERAGE OF SCREENING BARIUM ENEMA.—Not later than the ear- publication. Her of the date that is January 1, 1998, or 90 days after J^ use I395x the date of the enactment of this Act, the Secretary of Health and Human Services shall publish notice in the Federal Register with respect to the determination under paragraph (1)(D) of section 1861(pp) of the Social Security Act (42 U.S.C. 1395x(pp)), as added by paragraph (1), on the coverage of a screening barium enema as a colorectal cancer screening test under such section. (b) FREQUENCY LIMITS AND PAYMENT.— (1) IN GENERAL.— Section 1834 (42 U.S.C. 1395m) is amended by inserting after subsection (c) the following new subsection: "(d) FREQUENCY LIMITS AND PAYMENT FOR COLORECTAL CANCER SCREENING TESTS. — " (1) SCREENING FECAL-OCCULT BLOOD TESTS.— "(A) PAYMENT AMOUNT.— The payment amount for colorectal cancer screening tests consisting of screening fecal-occult blood tests is equal to the payment amount established for diagnostic fecal-occult blood tests under section 1833(h). "(B) FREQUENCY LIMIT. —NO payment may be made under this part for a colorectal cancer screening test consisting of a screening fecal-occult blood test— "(i) if the individual is under 50 years of age; or "(ii) if the test is performed within the 11 months after a previous screening fecal-occult blood test. "(2) SCREENING FLEXIBLE SIGMOIDOSCOPIES. — "(A) FEE SCHEDULE. —With respect to colorectal cancer screening tests consisting of screening flexible sigmoidoscopies, payment under section 1848 shall be consistent with payment under such section for similar or related services. "(B) PAYMENT LIMIT.— In the case of screening flexible sigmoidoscopy services, payment under this part shall not exceed such amount as the Secretary specifies, based upon the rates recognized for diagnostic flexible sigmoidoscopy services. " (C) FACILITY PAYMENT LIMIT.— "(i) IN GENERAL. — Notwithstanding subsections (i)(2)(A) and (t) of section 1833, in the case of screening

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