remains both under-recognized and under-treated. Over a 7-year period (2007–2013), 45 percent of older female Medicare beneficiaries had no DXA bone density test, and 25 percent had only one test. (10) Since 2007, Medicare has cut DXA reimbursement by over 70 percent. By 2016, the payment cuts caused a loss of 36 percent of DXA providers, resulting in a 21 percent decline in osteoporosis diagnosis and treatment. (11) A decade of steady decline in hip fractures stopped abruptly in 2013. Since then, there have been more than 24,000 additional hip fractures, costing over $1 billion, leading to 4,800 more deaths than expected if the decline had continued. 2. Increasing access to osteoporosis prevention and treatment Section 1848(b) of the Social Security Act ( 42 U.S.C. 1395w–4(b) ) is amended— (1) in paragraph (4)(B)— (A) by striking and the first 2 months of 2012 and inserting the first 2 months of 2012, 2019, and each subsequent year