1 54 (2) in subparagraph (B), by striking the semicolon at the end and inserting ", and"; and (3) by adding at the end the following new sub paragraph: "(C) tetanus-diphtheria booster and its ad ministration;". 2 3 4 5 6 7 (b) LIMITATION ON FREQUENCY.-Section 8 1862(a)(1) of such Act (42 U.S.C. 1395y(a)(1)), as 9 amended by section 502(b)(4)(A), is amended— 10 11 12 13 14 15 16 17 18 19 20 21 22 (1) in subparagraph (F), by striking "and" at the end; (2) in subparagraph (G), by striking the semicolon at the end and inserting ", and"; and (3) by adding at the end the following new subparagraph: "(H) in the case of an influenza vaccine, which is administered within the 11 months after a previous influenza vaccine, and, in the case of a tetanus-diphtheria booster, which is administered within the 119 months after a previous tetanus-diphtheria booster;". (c) CONFORMING AMENDMENT.-Section 1862(a)(7) 23 of such Act (42 U.S.C. 1395y(a)(7)), as amended by sec24 tion 502(b)(4)(B), is amended by striking "or (G)" and 25 inserting "(G), or (H)”. 55 1 (d) EFFECTIVE DATE.-The amendments made by 2 this section shall apply to influenza vaccines and tetanus 3 diphtheria boosters administered on or after January 1, 4 1992. 5 SEC. 503. COVERAGE OF WELL-CHILD CARE. 6 (a) IN GENERAL.-Section 1861(s) (2) of the Social 7 Security Act (42 U.S.C. 1395x(s)(2)) is amended— 8 9 10 11 12 13 14 15 16 17 18 (1) by striking "and" at the end of subparagraph (0); (2) by striking the semicolon at the end of subparagraph (P) and inserting “; and”; and (3) by adding at the end the following new subparagraph: "(Q) well-child services (as defined in subsection (11)(1)) provided to an individual entitled to benefits under this title who is under 19 years of age;". (b) SERVICES DEFINED.-Section 1861 of such Act 19, (42 U.S.C. 1395x) is amended (1) by redesignating the subsection (ij) added by section 4163 (a) (2) of the Omnibus Budget Rec onciliation Act of 1990 as subsection (kk); and (2) by inserting after subsection (kk) (as so re designated) the following new subsection: 1 2 56 "Well-Child Services "(1)(1) The term 'well-child services' means well 3 child care, including routine office visits, routine immuni4 zations (including the vaccine itself), routine laboratory 5 tests, and preventive dental care, provided in accordance 6 with the periodicity schedule established with respect to 7 the services under paragraph (2). 8 "(2) The Secretary, in consultation with the Amer9 ican Academy of Pediatrics, the Advisory Committee on 10 Immunization Practices, and other entities considered ap11 propriate by the Secretary, shall establish a schedule of 12 periodicity which reflects the appropriate frequency with 13 which the services referred to in paragraph (1) should be 14 provided to healthy children.". 15 (c) CONFORMING AMENDMENTS.-(1) Section 16 1862(a)(1) of such Act (42 U.S.C. 1395y(a)(1)), as 17 amended by sections 501(b)(4)(A) and 502(b), is 18 amended 19 20 21 22 23 24 (A) in subparagraph (G), by striking "and" at the end; (B) in subparagraph (H), by striking the semicolon at the end and inserting “, and"; and (C) by adding at the end the following new subparagraph: 1 2 3 4 5 6 57 "(I) in the case of well-child services, which are provided more frequently than is pro vided under the schedule of periodicity estab lished by the Secretary under section 1861(1)(2) for such services;". (2) Section 1862(a)(7) of such Act (42 U.S.C. 7 1395y(a)(7)), as amended by sections 502(b)(4)(B) and 8 503(c), is amended by striking "or (H)" and inserting 9 "(H), or (I)”. 10 (d) EFFECTIVE DATE.-The amendments made by 11 this section shall apply to well-child services provided on 12 or after January 1, 1992. 13 SEC. 504. ANNUAL SCREENING MAMMOGRAPHY. 14 (a) ANNUAL SCREENING MAMMOGRAPHY FOR 15 WOMEN OVER AGE 64.-Section 1834 (c)(2)(A) of the So 16 cial Security Act (42 U.S.C. 17 amended 18 19 20 21 1395m(b)(2)(A)) is (1) in clause (iv), by striking "but under 65 years of age,"; and (2) by striking clause (v). (b) EFFECTIVE DATE.--The amendments made by 22 subsection (a) shall apply to screening mammography per 23 formed on or after January 1, 1992. 58 1 SEC. 505. DEMONSTRATION PROJECTS FOR COVERAGE OF 2 3 OTHER PREVENTIVE SERVICES. (a) ESTABLISHMENT.-The Secretary of Health and 4 Human Services (in this section referred to as the "Sec5 retary") shall establish and provide for a series of ongoing 6 demonstration projects under which the Secretary shall 7 provide for coverage of the preventive services described 8 in subsection (c) under the medicare program in order to 9 determine 10 11 12 13 14 15 16 17 (1) the feasibility and desirability of expanding coverage of medical and other health services under the medicare program to include coverage of such services for all individuals enrolled under part B of title XVIII of the Social Security Act; and (2) appropriate methods for the delivery of those services to medicare beneficiaries. (b) SITES FOR PROJECT.-The Secretary shall pro 18 vide for the conduct of the demonstration projects estab19 lished under subsection (a) at the sites at which the Sec20 retary conducts the demonstration program established 21 under section 9314 of the Consolidated Omnibus Budget 22 Reconciliation Act of 1985 and at such other sites as the 23 Secretary considers appropriate. 24 (c) SERVICES COVERED UNDER PROJECTS.-The 25 Secretary shall cover the following services under the se |