12 2 STA T . 2 497PUBLIC LA W 11 0– 27 5—J UL Y 15 , 200 8‘ ‘ (C)ap p ro pr i a tef ori nd i v id u a ls entitled to b enefits under part A or enrolled under part B. ‘‘( 2 ) I n m a k in g determinations under paragrap h ( 1 ) regarding the c overage of a ne w service , the S ecretar y shall use the process for making national coverage determinations (as defined in section 1 869 (f)(1)(B)) under this title. As part of the use of such process, the Secretary may conduct an assessment of the relation between predicted outcomes and the e x penditures for such service and may take into account the results of such assessment in making such determination. ’ ’. (2) PAYMENT AN DCOI N SUR ANCE F OR ADDITIONA LP RE V EN - TIVE SERVICES. — Section 18 3 3(a)(1) of the Social Security Act ( 4 2 U .S.C. 139 5 l(a)(1)) is amended— (A) by striking ‘‘and’’ before ‘‘( V )’’
and (B) by inserting before the semicolon at the end the following
‘‘, and ( W ) with respect to additional preventive services (as defined in section 1861(ddd)(1)), the amount paid shall be (i) in the case of such services which are clinical diagnostic laboratory tests, the amount determined under subparagraph ( D ), and (ii) in the case of all other such services, 8 0 percent of the lesser of the actual charge for the service or the amount determined under a fee schedule established by the Secretary for purposes of this subparagraph’’. (3) CONFORMIN G AMENDMENT REGARDING COVERAGE.—Sec- tion 1862(a)(1)(A) of the Social Security Act (42 U.S.C. 1395y(a)(1)(A)) is amended by inserting ‘‘or additional preven- tive services (as described in section 1861(ddd)(1))’’ after ‘‘suc- ceeding subparagraph’’. (4) R ULE OF CONSTRUCTION.— N othing in the provisions of, or amendments made by, this subsection shall be construed to provide coverage under title X VIII of the Social Security Act of items and services for the treatment of a medical condi- tion that is not otherwise covered under such title. (b) REVISIONS TO INITIAL PREVENTIVE P H YSICAL EX AMINA- TION.— (1) IN GENERAL.—Section 1861(ww) of the Social Security Act (42 U.S.C. 1395x(ww)) is amended— (A) in paragraph (1)— (i) by inserting ‘‘body mass index,’’ after ‘‘weight’’; (ii) by striking ‘‘, and an electrocardiogram’’; and (iii) by inserting ‘‘and end-of-life planning (as defined in paragraph (3)) upon the agreement with the individual’’ after ‘‘paragraph (2)’’; (B) in paragraph (2), by adding at the end the following new subparagraphs: ‘‘( M ) An electrocardiogram. ‘‘(N) Additional preventive services (as defined in subsection (ddd)(1)).’’; and (C) by adding at the end the following new paragraph: ‘‘(3) F or purposes of paragraph (1), the term ‘end-of-life plan- ning’ means verbal or written information regarding— ‘‘(A) an individual’s ability to prepare an advance directive in the case that an in j ury or illness causes the individual to be unable to make health care decisions; and ‘‘(B) whether or not the physician is willing to follow the individual’s wishes as expressed in an advance directive.’’. 42USC1395lnote.
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