article: 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.
summary: 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.