text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Medicaid Mammography Coverage Act of 
  1993''.
  
  SEC. 2. COVERAGE OF SCREENING MAMMOGRAPHY UNDER MEDICAID.
  
      (a) In General.--Section 1905(a) of the Social Security Act (42 
  U.S.C. 1396d(a)), as amended by the Omnibus Budget Reconciliation Act 
  of 1990, is amended--
              (1) by striking ``and'' at the end of paragraph (21);
              (2) in paragraph (24), by striking the comma at the end and 
          inserting a semicolon;
              (3) by redesignating paragraphs (22), (23), and (24) as 
          paragraphs (21), (22), and (23), respectively, and by 
          transferring and inserting paragraph (25) after paragraph (23), 
          as so redesignated; and
              (4) by inserting after paragraph (23) the following new 
          paragraph:
              ``(24) screening mammography (as defined in subsection 
          (t)(1)) that meets the quality standards established under 
          section 1834(c)(3), to the extent consistent with the frequency 
          permitted under subsection (t)(2); and''.
      (b) Frequency of Coverage.--Section 1905 of the Social Security Act 
  (42 U.S.C. 1396d) is amended by adding at the end the following new 
  subsection:
      ``(t) Coverage of Screening Mammography.--
              ``(1) Definition.--The term `screening mammography' means 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.
              ``(2) Frequency covered.--
                      ``(A) In general.--Subject to revision by the 
                  Secretary under subparagraph (B)--
                              ``(i) Medical assistance is not required to 
                          be made under this title for screening 
                          mammography performed on a woman under 35 years 
                          of age.
                              ``(ii) Medical assistance is available 
                          under this title 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), medical assistance is not 
                                  required to be made available under 
                                  this title for a screening mammography 
                                  performed within 11 months of a 
                                  previous screening mammography, or
                                      ``(II) is not at a high risk of 
                                  developing breast cancer, medical 
                                  assistance is not required to be made 
                                  available under this title for a 
                                  screening mammography performed within 
                                  23 months of a previous screening 
                                  mammography.
                              ``(iv) In the case of a woman over 49 years 
                          of age, medical assistance is not required to 
                          be made available under this title for 
                          screening mammography performed within 11 
                          months of a previous screening mammography.
                      ``(B) Revision of frequency.--
                              ``(i) Review.--The Secretary, in 
                          consultation with the Director of the National 
                          Cancer Institute, shall review periodically 
                          appropriate frequency for performing screening 
                          mammography, 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 medical 
                          assistance is required to be made available 
                          under this title, but no such revision shall 
                          apply to screening mammography performed before 
                          January 1, 1993.''.
      (c) Conforming Amendments.--(1) Section 1902(a)(10(A) of such Act 
  (42 U.S.C. 1396a(a)(10)(A)) is amended by striking ``(17) and (21)'' 
  and inserting ``(17), (21) and (24)''.
      (2) Section 1902(a)(10)(C)(iv) (42 U.S.C. 1396a(a)(10)(C)(iv)) is 
  amended--
              (A) by striking ``(5) and (17)'' and inserting ``(5), (17), 
          and (24)''; and
              (B) by striking ``through (21)'' and inserting ``through 
          (24)''.
      (3) Section 1902(j) (42 U.S.C. 1396a(j)) is amended by striking 
  ``through (22)'' and inserting ``through (24)''.
      (4) Sections 1916(a)(2)(D) and 1916(b)(2)(D) (42 U.S.C. 
  1396o(a)(2)(D), 1396o(b)(2)(D)) are each amended by inserting 
  ``services described in section 1905(a)(24)'' before ``family planning 
  services''.
      (d) Effective Date.--(1) Except as provided in paragraph (2), the 
  amendments made by subsections (a), (b), and (c) shall apply to 
  screening mammography performed on or after January 1, 1994, without 
  regard to whether or not final regulations to carry out such amendments 
  have been promulgated by such date.
      (2) In the case of a State plan for medical assistance under title 
  XIX of the Social Security Act which the Secretary of Health and Human 
  Services determines requires State legislation (other than legislation 
  appropriating funds) in order for the plan to meet the additional 
  requirement imposed by the amendments made by this section, the State 
  plan shall not be regarded as failing to comply with the requirements 
  of such title solely on the basis of its failure to meet this 
  additional requirement before the first day of the first calendar 
  quarter beginning after the close of the first regular session of the 
  State legislature that begins after the date of the enactment of this 
  Act. For purposes of the previous sentence, in the case of a State that 
  has a 2-year legislative session, each year of such session shall be 
  deemed to be a separate regular session of the State legislature.
target: Medicaid Mammography Coverage Act of 1993 - Amends title XIX (Medicaid) of the Social Security Act to provide Medicaid coverage of screening mammographies for women age 35 and older.  Varies the permissible frequency of such covered tests on the basis of a woman's age and her risk of developing breast cancer. Directs the Secretary to periodically review and revise permissible frequencies of such tests.
feat_title: Medicaid Mammography Coverage Act of 1993