text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Prostate Cancer Diagnosis and 
  Treatment Act of 1997''.
  
  SEC. 2. MEDICARE COVERAGE OF PROSTATE CANCER SCREENING AND CERTAIN DRUG 
                TREATMENTS.
  
      (a) Coverage of Screening Services.--
              (1) In general.--Section 1861(s)(2) of the Social Security 
          Act (42 U.S.C. 1395x(s)(2)) is amended--
                      (A) by striking ``and'' at the end of subparagraph 
                  (N);
                      (B) by striking ``and'' at the end of subparagraph 
                  (O); and
                      (C) by inserting after subparagraph (O) the 
                  following new subparagraph:
              ``(P) services for the early detection of prostate cancer 
          (as defined in subsection (oo)); and''.
              (2) Services described.--Section 1861 of such Act (42 
          U.S.C. 1395x) is amended by adding at the end the following new 
          subsection:
  
           ``Services for the Early Detection of Prostate Cancer
  
      ``(oo) The term `services for the early detection of prostate 
  cancer' means the following procedures provided to a man for the 
  purpose of early detection of prostate cancer:
              ``(1) Digital rectal examination.
              ``(2) Prostate-specific antigen blood test.
              ``(3) Transrectal ultrasonography.
              ``(4) Such other procedures as the Secretary may designate 
          as appropriate for early detection of prostate cancer.''.
              (3) Payment amounts; limitations on frequency of 
          coverage.--Section 1834 of such Act (42 U.S.C. 1395m) is 
          amended by inserting after subsection (c) the following new 
          subsection:
      ``(d) Payment Amounts and Frequency Limits for Services for the 
  Early Detection of Prostate Cancer.--
              ``(1) In general.--Notwithstanding any other provision of 
          this part, with respect to expenses incurred for services for 
          the early detection of prostate cancer (as defined in section 
          1861(oo))--
                      ``(A) payment may be made only for services 
                  provided consistent with the frequency permitted under 
                  paragraph (2); and
                      ``(B) the amount of the payment under this part 
                  shall be equal to 80 percent of the lesser of the 
                  actual charge for the service or--
                              ``(i) in the case of a service for the 
                          early detection of prostate cancer consisting 
                          of a prostate-specific antigen blood test, the 
                          fee schedule amount established for the service 
                          under section 1833(h) (relating to payments for 
                          clinical diagnostic laboratory tests); or
                              ``(ii) in the case of any other service for 
                          the early detection of prostate cancer, the 
                          amount provided under the fee schedule 
                          established by the Secretary under paragraph 
                          (3) (subject to the deductible established 
                          under section 1833(b)).
              ``(2) Frequency covered.--
                      ``(A) In general.--Subject to subparagraph (B) and 
                  to revision by the Secretary under subparagraph (C), no 
                  payment may be made under this part for a service for 
                  the early detection of prostate cancer provided to an 
                  individual--
                              ``(i) if the individual is under 50 years 
                          of age; or
                              ``(ii) if the service is provided within 
                          the 11 months after a previous service for the 
                          early detection of prostate cancer.
                      ``(B) Exception for high risk individuals.--Payment 
                  may be made under this part for a service for the early 
                  detection of prostate cancer provided to an individual 
                  more frequently than the limit established under 
                  subparagraph (A)(ii) if the individual is at a high 
                  risk of developing prostate cancer (as determined 
                  pursuant to factors identified by the Secretary).
                      ``(C) Revision by secretary.--
                              ``(i) Review.--The Secretary, in 
                          consultation with the Director of the National 
                          Cancer Institute, shall review periodically the 
                          appropriate frequency for performing services 
                          for the early detection of prostate cancer 
                          based on age and such other factors as the 
                          Secretary believes to be pertinent.
                              ``(ii) Revision of frequency.--The 
                          Secretary, taking into consideration the review 
                          made under clause (i), may revise from time to 
                          time the frequency with which such services may 
                          be paid for under this subsection, but no such 
                          revision shall apply to services performed 
                          before January 1, 2000.
              ``(3) Establishment of fee schedule.--
                      ``(A) In general.--The Secretary shall establish 
                  fee schedules (on such geographic basis as the 
                  Secretary considers appropriate) for payment for 
                  services for the early detection of prostate cancer 
  under this part (other than prostate-specific antigen blood tests), 
  effective for services furnished after the expiration of the 90-day 
  period beginning on the date the Secretary establishes the fee 
  schedules.
                      ``(B) Factors considered.--In establishing fee 
                  schedules under subparagraph (A), the Secretary shall 
                  take into consideration variations in the cost of 
                  furnishing such services among geographic areas and 
                  among different sites where services are furnished, 
                  together with such other factors as may be appropriate 
                  to assure that payment amounts are equitable.
              ``(4) Limiting charges of nonparticipating physicians.--In 
          the case of a service for the early detection of prostate 
          cancer for which payment may be made under this part, if a 
          nonparticipating physician or nonparticipating supplier or 
          other person (as defined in section 1842(i)(2)) who does not 
          accept payment on an assignment-related basis provides the 
          service to an individual enrolled under this part, section 
          1848(g)(1) shall apply to the service in the same manner as 
          such section applies to a physician's service.''.
              (4) Conforming amendments.--(A) Paragraphs (1)(D) and 
          (2)(D) of section 1833(a) of such Act (42 U.S.C. 1395l(a)) are 
          each amended by striking ``subsection (h)(1),'' and inserting 
          ``subsection (h)(1) or section 1834(d)(1)(B)(i),''.
              (B) Section 1833(a)(1) of such Act (42 U.S.C. 1395l(a)(1)) 
          is amended--
                      (i) by striking ``and (P)'' and inserting ``(P)''; 
                  and
                      (ii) by striking the semicolon at the end and 
                  inserting the following: ``, and (Q) with respect to 
                  services for the early detection of prostate cancer (as 
                  defined in section 1861(oo)) (other than prostate-
                  specific antigen tests), the amounts paid shall be the 
                  amounts described in section 1834(d)(1);''.
              (C) Section 1833(a) of such Act (42 U.S.C. 1395l(a)) is 
          amended--
                      (i) by striking ``and'' at the end of paragraph 
                  (6);
                      (ii) by striking the period at the end of paragraph 
                  (7) and inserting ``; and''; and
                      (iii) by adding at the end the following new 
                  paragraph:
              ``(8) in the case of services for the early detection of 
          prostate cancer (as defined in section 1861(oo)) (other than 
          prostate-specific antigen tests), the amounts described in 
          section 1834(d)(1).''.
              (D) Section 1833(h)(1)(A) of such Act (42 U.S.C. 
          1395l(h)(1)(A)) is amended by striking ``The Secretary'' and 
          inserting ``Subject to section 1834(d), the Secretary''.
              (E) Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is 
          amended--
                      (i) in paragraph (1)--
                              (I) in subparagraph (E), by striking 
                          ``and'' at the end,
                              (II) in subparagraph (F), by striking the 
                          semicolon at the end and inserting ``, and'', 
                          and
                              (III) by adding at the end the following 
                          new subparagraph:
              ``(G) in the case of services for the early detection of 
          prostate cancer (as defined in section 1861(oo)), which are 
          performed more frequently than is covered under section 
          1834(d)(2);''; and
                      (ii) in paragraph (7), by striking ``paragraph 
                  (1)(B) or under paragraph (1)(F)'' and inserting 
  ``subparagraphs (B), (F), or (G) of paragraph (1)''.
      (b) Coverage of Certain Drug Treatments.--Section 1861(s)(2) of the 
  Social Security Act (42 U.S.C. 1395x(s)(2)), as amended by subsection 
  (a)(1), is further amended--
              (1) by striking ``and'' at the end of subparagraph (P);
              (2) by adding ``and'' at the end of subparagraph (Q); and
              (3) by adding at the end the following new subparagraph:
              ``(R) an oral drug prescribed for the treatment of prostate 
          cancer, if the use of the drug for such purpose is a medically 
          accepted indication under subsection (t)(2);''.
      (c) Effective Date.--The amendments made by this section shall 
  apply to services provided on or after January 1, 1998, without regard 
  to whether or not the Secretary has established fee schedules under 
  section 1834(d)(3) of the Social Security Act (as added by subsection 
  (a)(3)) or promulgated other regulations to carry out such amendments 
  by that date.
  
  SEC. 3. EARLY DETECTION AND TREATMENT OF PROSTATE CANCER IN VETERANS.
  
      (a) Preventive Health Services.--Section 1701(9) of title 38, 
  United States Code is amended--
              (1) by redesignating subparagraphs (J) and (K) as 
          subparagraphs (K) and (L), respectively; and
              (2) by inserting after subparagraph (I) the following new 
          subparagraph (J):
              ``(J) tests for the early detection and diagnosis of 
          prostate cancer;''.
      (b) Coverage of Services for Early Detection and Treatment of 
  Prostate Cancer.--
              (1) In general.--Chapter 17 of such title is amended by 
          inserting after section 1724 the following new section:
  ``Sec. 1725. Prostate cancer detection and treatment
      ``(a) The Secretary shall include in the medical services furnished 
  to veterans under this chapter--
              ``(1) services for the early detection and treatment of 
          prostate cancer;
              ``(2) information on the early detection and treatment of 
          prostate cancer; and
              ``(3) counseling regarding prostate cancer.
      ``(b) Based on the best available medical evidence, the Secretary 
  shall implement a schedule for early detection of prostate cancer for 
  veterans confined to hospitals or other institutions.
      ``(c) For the purposes of this section--
              ``(1) services for the early detection of prostate cancer 
          are procedures provided to a male for the purpose of the early 
          detection of prostate cancer, including digital rectal 
          examinations, prostate-specific antigen blood tests, and 
          transrectal ultrasonography; and
              ``(2) services for treatment of prostate cancer may include 
          the furnishing of drugs approved by the Food and Drug 
          Administration for the treatment of prostate cancer.
      ``(d) The Secretary may carry out research and research training in 
  the diagnosis and treatment of prostate cancer based upon the prostate 
  cancer services provided under this section and may develop guidelines 
  outlining effective treatment regimens for prostate cancer.''.
              (2) Clerical amendment.--The table of sections at the 
          beginning of such chapter is amended by inserting after the 
          item relating to section 1724 the following new item:
  
  ``1725. Prostate cancer detection and treatment.''.
target: Prostate Cancer Diagnosis and Treatment Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of services for the early detection of prostate cancer and certain drug treatments for such cancer.  Requires the Secretary of Health and Human Services to establish fee schedules for such services. 
  Amends Federal law to cover such detection and treatment services for veterans as a preventive health service.
feat_title: Prostate Cancer Diagnosis and Treatment Act of 1997