; and (B) by inserting or screening computed tomography colonography after screening flexible sigmoidoscopy . (d) Effective date The amendments made by this section shall apply to items and services furnished on or after January 1, 2019. 3. Exemption of screening computed tomography colonography from special rule on payment for imaging services (a) In general Section 1848(b)(4)(B) of the Social Security Act ( 42 U.S.C. 1395w–4(b)(4)(B) ) is amended by inserting and screening computed tomography colonography after diagnostic and screening mammography . (b) Effective date The amendment made by subsection (a) shall apply to items and services furnished on or after January 1, 2019. 4. Reports on the status of covering computed tomography colonography as a colorectal cancer screening test under Medicare (a) Preliminary report Not later than 90 days after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit a preliminary report to Congress on the status of coverage of computed tomography colonography as a colorectal cancer screening test under the Medicare program under title XVIII of the Social Security Act, including the extent to which such coverage as required by the amendments made by sections 2 and 3 has been implemented. (b) Annual report Not later than September 30 of each fiscal year during the 5-year period beginning with fiscal year 2020, the Secretary shall submit to the Congress, a status report on the following: (1) The impact of screening computed tomography colonography on the change in colorectal cancer screening compliance of Medicare beneficiaries. (2) The various utilization rates with respect to Medicare beneficiaries for each available colorectal cancer screening option before and after the availability of and coverage of screening computed tomography colonography under the Medicare program pursuant to the enactment of this Act, including— (A) by initial CRC screening performed with respect to a Medicare beneficiary per year, including the age of the