HR9417-118

1. Short title This Act may be cited as the Early Access to Screening Act.

2. No-cost coverage of annual screening mammography beginning at 30 years of age Section 1834(c) of the Social Security Act (42 U.S.C. 1395m(c)) is amended— in paragraph (1)(A), by inserting or (3) after paragraph (2); in paragraph (2)— by striking the paragraph heading and inserting Frequency covered before January 1, 2025; and in subparagraph (A), by striking Subject and inserting With respect to screening mammography performed before January 1, 2025, subject; and by adding at the end the following new paragraph: With respect to screening mammography performed on or after January 1, 2025— no payment may be made under this part for screening mammography performed on a woman under 30 years of age; and in the case of a woman over 29 years of age, payment may not be made under this part for screening mammography performed within 11 months following the month in which a previous screening mammography was performed. Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended— in subparagraph (Y), by inserting after “in the case of such services described in subparagraph (A)” the following: “(other than screening mammography (as defined in section 1861(jj)) performed on or after January 1, 2025)”; in subparagraph (GG), by striking and at the end; and by inserting before the semicolon at the end the following: , and (II) with respect to screening mammography (as defined in section 1861(jj)) performed on or after January 1, 2025, the amounts paid shall be shall be 100 percent of the lesser of the actual charge for the services or the amount determined under the fee schedule that applies to such services under this part. Section 1862(a)(1)(F) is amended by striking section 1834(c)(2) and inserting section 1834(c). Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by inserting (13)(D), before (17),. Section 1902(a)(10)(C)(iv) of the Social Security Act (42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by inserting (13)(D), before and (17). Section 1937(b) of the Social Security Act (42 U.S.C. 1396u–7(b)) is amended by adding at the end the following new paragraph: Notwithstanding the previous provisions of this section, a State may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark-equivalent coverage under this section unless, beginning on January 1, 2025, for any individual over age 29, such coverage includes (and does not impose any deduction, cost sharing, or similar charge for) annual screening mammography described in section 1905(a)(13)(D). Section 1905(a)(13) of the Social Security Act (42 U.S.C. 1396d(a)(13)) is amended— in subparagraph (B), by striking and at the end; in subparagraph (C), by adding and at the end; and by adding at the end the following new subparagraph: beginning January 1, 2025, for individuals over age 29, annual screening mammography; Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended— in subsection (a)(2)— in subparagraph (I), by striking or at the end; in subparagraph (J), by striking ; and at the end and inserting , or; and by adding at the end the following new subparagraph: beginning January 1, 2025, annual screening mammography described in section 1905(a)(13)(D); and in subsection (b)(2)— in subparagraph (I), by striking or at the end; in subparagraph (J), by striking ; and at the end and inserting , or; and by adding at the end the following new subparagraph: beginning January 1, 2025, annual screening mammography described in section 1905(a)(13)(D); and Section 1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended by adding at the end the following new clause: Beginning January 1, 2025, annual screening mammography described in section 1905(a)(13)(D). Section 2713(a) of the Public Health Service Act (42 U.S.C. 300gg–13(a)) is amended— in paragraph (2), by striking at the end and; in paragraph (3), by striking at the end the period and inserting ; and; and in paragraph (4)— by striking at the end the period and inserting ; and; by striking women, such and inserting women— such by adding at the end the following new subparagraph: in the case of a woman over 29 years of age, annual mammography screening. The amendments made by this subsection shall apply to plan years beginning on or after January 1, 2025. (3)Frequency covered on or after January 1, 2025With respect to screening mammography performed on or after January 1, 2025—(A)no payment may be made under this part for screening mammography performed on a woman under 30 years of age; and(B)in the case of a woman over 29 years of age, payment may not be made under this part for screening mammography performed within 11 months following the month in which a previous screening mammography was performed.. (9)Annual screening mammographyNotwithstanding the previous provisions of this section, a State may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark-equivalent coverage under this section unless, beginning on January 1, 2025, for any individual over age 29, such coverage includes (and does not impose any deduction, cost sharing, or similar charge for) annual screening mammography described in section 1905(a)(13)(D).. (D)beginning January 1, 2025, for individuals over age 29, annual screening mammography;. (K)beginning January 1, 2025, annual screening mammography described in section 1905(a)(13)(D); and; and (K)beginning January 1, 2025, annual screening mammography described in section 1905(a)(13)(D); and. (xv)Beginning January 1, 2025, annual screening mammography described in section 1905(a)(13)(D).. women—(A)such; and (B)in the case of a woman over 29 years of age, annual mammography screening..