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1 higher costs effective for services furnished on
2 or after January 1, 2011.’’.
3 SEC. 1146. MEDICARE IMPROVEMENT FUND.

4 Section 1898(b)(1)(A) of the Social Security Act (42

5 U.S.C. 1395iii(b)(1)(A)) is amended to read as follows:
6 ‘‘(A) the period beginning with fiscal year
7 2011 and ending with fiscal year 2019,
8 $8,000,000,000; and’’.
9 SEC. 1147. PAYMENT FOR IMAGING SERVICES.

10 (a) ADJUSTMENT IN PRACTICE EXPENSE TO RE -

11 FLECT HIGHER PRESUMED UTILIZATION.—Section 1848
12 of the Social Security Act (42 U.S.C. 1395w) is amend-
13 ed—
14 (1) in subsection (b)(4)—
15 (A) in subparagraph (B), by striking ‘‘sub-
16 paragraph (A)’’ and inserting ‘‘this paragraph’’;
17 and
18 (B) by adding at the end the following new
19 subparagraph:
20 ‘‘(C) ADJUSTMENT IN PRACTICE EXPENSE

21 TO REFLECT HIGHER PRESUMED UTILIZA-

22 TION.—In computing the number of practice

23 expense relative value units under subsection
24 (c)(2)(C)(ii) with respect to advanced diagnostic
25 imaging services (as defined in section

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1 1834(e)(1)(B)) , the Secretary shall adjust such
2 number of units so it reflects a 75 percent
3 (rather than 50 percent) presumed rate of utili-
4 zation of imaging equipment.’’; and
5 (2) in subsection (c)(2)(B)(v)(II), by inserting
6 ‘‘AND OTHER PROVISIONS’’ after ‘‘OPD PAYMENT

7 CAP’’.

8 (b) ADJUSTMENT IN TECHNICAL COMPONENT ‘‘DIS-

9 COUNT’’ ON SINGLE-SESSION IMAGING TO CONSECUTIVE
10 BODY PARTS.—Section 1848(b)(4) of such Act is further
11 amended by adding at the end the following new subpara-
12 graph:
13 ‘‘(D) ADJUSTMENT IN TECHNICAL COMPO-

14 NENT DISCOUNT ON SINGLE-SESSION IMAGING

15 INVOLVING CONSECUTIVE BODY PARTS.—The

16 Secretary shall increase the reduction in ex-

17 penditures attributable to the multiple proce-
18 dure payment reduction applicable to the tech-
19 nical component for imaging under the final
20 rule published by the Secretary in the Federal
21 Register on November 21, 2005 (part 405 of
22 title 42, Code of Federal Regulations) from 25
23 percent to 50 percent.’’.
24 (c) EFFECTIVE DATE.—Except as otherwise pro-
25 vided, this section, and the amendments made by this sec-

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1 tion, shall apply to services furnished on or after January
2 1, 2011.
3 SEC. 1148. DURABLE MEDICAL EQUIPMENT PROGRAM IM-

4 PROVEMENTS.

5 (a) WAIVER OF SURETY BOND REQUIREMENT.—Sec-

6 tion 1834(a)(16) of the Social Security Act (42 U.S.C.
7 1395m(a)(16)) is amended by adding at the end the fol-
8 lowing: ‘‘The requirement for a surety bond described in
9 subparagraph (B) shall not apply in the case of a phar-
10 macy (i) that has been enrolled under section 1866(j) as
11 a supplier of durable medical equipment, prosthetics,
12 orthotics, and supplies and has been issued (which may
13 include renewal of) a provider number (as described in the
14 first sentence of this paragraph) for at least 5 years, and
15 (ii) for which a final adverse action (as defined in section
16 424.57(a) of title 42, Code of Federal Regulations) has
17 never been imposed.’’.
18 (b) ENSURING SUPPLY OF OXYGEN EQUIPMENT .—
19 (1) IN GENERAL.—Section 1834(a)(5)(F) of the
20 Social Security Act (42 U.S.C. 1395m(a)(5)(F)) is
21 amended—
22 (A) in clause (ii), by striking ‘‘After the’’
23 and inserting ‘‘Except as provided in clause
24 (iii), after the’’; and

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1 (B) by adding at the end the following new
2 clause:
3 ‘‘(iii) CONTINUATION OF SUPPLY.—In

4 the case of a supplier furnishing such

5 equipment to an individual under this sub-
6 section as of the 27th month of the 36
7 months described in clause (i), the supplier
8 furnishing such equipment as of such
9 month shall continue to furnish such
10 equipment to such individual (either di-
11 rectly or though arrangements with other
12 suppliers of such equipment) during any
13 subsequent period of medical need for the
14 remainder of the reasonable useful lifetime
15 of the equipment, as determined by the
16 Secretary, regardless of the location of the
17 individual, unless another supplier has ac-
18 cepted responsibility for continuing to fur-
19 nish such equipment during the remainder
20 of such period.’’.
21 (2) EFFECTIVE DATE.—The amendments made
22 by paragraph (1) shall take effect as of the date of
23 the enactment of this Act and shall apply to the fur-
24 nishing of equipment to individuals for whom the
25 27th month of a continuous period of use of oxygen

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1 equipment described in section 1834(a)(5)(F) of the
2 Social Security Act occurs on or after July 1, 2010.
3 (c) TREATMENT OF CURRENT ACCREDITATION AP-
4 PLICATIONS.—Section 1834(a)(20)(F) of such Act (42
5 U.S.C. 1395m(a)(20)(F)) is amended—
6 (1) in clause (i)—
7 (A) by striking ‘‘clause (ii)’’ and inserting
8 ‘‘clauses (ii) and (iii)’’; and
9 (B) by striking ‘‘and’’ at the end;
10 (2) by striking the period at the end of clause
11 (ii)(II) and by inserting ‘‘; and’’; and
12 (3) by adding at the end the following:
13 ‘‘(iii) the requirement for accredita-
14 tion described in clause (i) shall not apply
15 for purposes of supplying diabetic testing
16 supplies, canes, and crutches in the case of
17 a pharmacy that is enrolled under section
18 1866(j) as a supplier of durable medical
19 equipment, prosthetics, orthotics, and sup-
20 plies.
21 Any supplier that has submitted an application
22 for accreditation before August 1, 2009, shall
23 be deemed as meeting applicable standards and
24 accreditation requirement under this subpara-
25 graph until such time as the independent ac-

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1 creditation organization takes action on the
2 supplier’s application.’’.
3 (d) RESTORING 36-MONTH OXYGEN RENTAL PE-
4 RIOD IN CASE OF SUPPLIER BANKRUPTCY FOR CERTAIN
5 INDIVIDUALS.—Section 1834(a)(5)(F) of such Act (42
6 U.S.C. 1395m(a)(5)(F)) is amended by adding at the end
7 the following new clause:
8 ‘‘(iii) EXCEPTION FOR BANK-

9 RUPTCY.—If a supplier of oxygen to an in-

10 dividual is declared bankrupt and its assets
11 are liquidated and at the time of such dec-
12 laration and liquidation more than 24
13 months of rental payments have been
14 made, the individual may begin under this
15 subparagraph a new 36-month rental pe-
16 riod with another supplier of oxygen.’’.
17 SEC. 1149. MEDPAC STUDY AND REPORT ON BONE MASS

18 MEASUREMENT.

19 (a) IN GENERAL.—The Medicare Payment Advisory

20 Commission shall conduct a study regarding bone mass
21 measurement, including computed tomography, duel-en-
22 ergy x-ray absorptriometry, and vertebral fracture assess-
23 ment. The study shall focus on the following:
24 (1) An assessment of the adequacy of Medicare
25 payment rates for such services, taking into account

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1 costs of acquiring the necessary equipment, profes-
2 sional work time, and practice expense costs.
3 (2) The impact of Medicare payment changes
4 since 2006 on beneficiary access to bone mass meas-
5 urement benefits in general and in rural and minor-
6 ity communities specifically.
7 (3) A review of the clinically appropriate and
8 recommended use among Medicare beneficiaries and
9 how usage rates among such beneficiaries compares
10 to such recommendations.
11 (4) In conjunction with the findings under (3),
12 recommendations, if necessary, regarding methods
13 for reaching appropriate use of bone mass measure-
14 ment studies among Medicare beneficiaries.
15 (b) REPORT.—The Commission shall submit a report
16 to the Congress, not later than 9 months after the date
17 of the enactment of this Act, containing a description of
18 the results of the study conducted under subsection (a)
19 and the conclusions and recommendations, if any, regard-
20 ing each of the issues described in paragraphs (1), (2) (3)
21 and (4) of such subsection.

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1 Subtitle C—Provisions Related to
2 Medicare Parts A and B
3 SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOS-

4 PITAL READMISSIONS.

5 (a) HOSPITALS.—
6 (1) IN GENERAL.—Section 1886 of the Social
7 Security Act (42 U.S.C. 1395ww), as amended by
8 section 1103(a), is amended by adding at the end
9 the following new subsection:
10 ‘‘(p) ADJUSTMENT TO HOSPITAL PAYMENTS FOR

11 EXCESS READMISSIONS.—
12 ‘‘(1) IN GENERAL.—With respect to payment
13 for discharges from an applicable hospital (as de-
14 fined in paragraph (5)(C)) occurring during a fiscal
15 year beginning on or after October 1, 2011, in order
16 to account for excess readmissions in the hospital,
17 the Secretary shall reduce the payments that would
18 otherwise be made to such hospital under subsection
19 (d) (or section 1814(b)(3), as the case may be) for
20 such a discharge by an amount equal to the product
21 of—
22 ‘‘(A) the base operating DRG payment
23 amount (as defined in paragraph (2)) for the
24 discharge; and

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