[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 2736 Referred in House (RFH)]
<DOC>
114th CONGRESS
2d Session
S. 2736
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 21, 2016
Referred to the Committee on Energy and Commerce, and in addition to
the Committee on Ways and Means, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
AN ACT
To improve access to durable medical equipment for Medicare
beneficiaries under the Medicare program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Patient Access to Durable Medical
Equipment Act of 2016''.
SEC. 2. EXTENSION OF THE TRANSITION TO NEW PAYMENT RATES FOR DURABLE
MEDICAL EQUIPMENT UNDER THE MEDICARE PROGRAM.
The Secretary of Health and Human Services shall extend the
transition period described in clause (i) of section 414.210(g)(9) of
title 42, Code of Federal Regulations, from June 30, 2016, to June 30,
2017 (with the full implementation described in clause (ii) of such
section applying to items and services furnished with dates of service
on or after July 1, 2017).
SEC. 3. FLOOR ON BID CEILING FOR COMPETITIVE ACQUISITION FOR DURABLE
MEDICAL EQUIPMENT UNDER THE MEDICARE PROGRAM.
Section 1847(b)(5) of the Social Security Act (42 U.S.C. 1395w-
3(b)(5)) is amended--
(1) in subparagraph (A)--
(A) by inserting ``, subject to subparagraph (E),''
after ``subsection (a)(2)''; and
(B) by inserting ``, subject to subparagraph (E),''
after ``Based on such bids''; and
(2) by adding at the end the following new subparagraph:
``(E) Floor on bid ceiling for durable medical
equipment.--
``(i) In general.--The ceiling for a bid
submitted for applicable covered items may not
be less than the fee schedule amount that would
otherwise be determined under section 1834(a),
section 1834(h), or section 1842(s) for such
items furnished on July 1, 2016 (determined as
if section 2 of the Patient Access to Durable
Medical Equipment Act of 2016 had not been
enacted).
``(ii) Applicable covered items defined.--
For purposes of this subparagraph, the term
`applicable covered items' means competitively
priced items and services described in
subsection (a)(2) that are furnished with
respect to rounds of competition that begin on
or after January 1, 2017.''.
SEC. 4. REQUIREMENTS IN DETERMINING ADJUSTMENTS USING INFORMATION FROM
COMPETITIVE BIDDING PROGRAMS.
(a) In General.--Section 1834(a)(1)(G) of the Social Security Act
(42 U.S.C. 1395m(a)(1)(G)) is amended by adding at the end the
following new sentence: ``In the case of items and services furnished
on or after January 1, 2019, in making any adjustments under clause
(ii) or (iii) of subparagraph (F), under subsection (h)(1)(H)(ii), or
under section 1842(s)(3)(B), the Secretary shall--
``(i) solicit and take into account
stakeholder input; and
``(ii) take into account the highest amount
bid by a winning supplier in a competitive
acquisition area and a comparison of each of
the following with respect to non-competitive
acquisition areas and competitive acquisition
areas:
``(I) The average travel distance
and cost associated with furnishing
items and services in the area.
``(II) Any barriers to access for
items and services in the area.
``(III) The average delivery time
in furnishing items and services in the
area.
``(IV) The average volume of items
and services furnished by suppliers in
the area.
``(V) The number of suppliers in
the area.''.
(b) Conforming Amendments.--(1) Section 1834(h)(1)(H)(ii) of the
Social Security Act (42 U.S.C. 1395m(h)(1)(H)(ii)) is amended by
striking ``the Secretary'' and inserting ``subject to subsection
(a)(1)(G), the Secretary''.
(2) Section 1842(s)(3)(B) of the Social Security Act (42 U.S.C.
1395m(s)(3)(B)) is amended by striking ``the Secretary'' and inserting
``subject to section 1834(a)(1)(G), the Secretary''.
SEC. 5. REPORTS ON THE RESULTS OF THE MONITORING OF ACCESS OF MEDICARE
BENEFICIARIES TO DURABLE MEDICAL EQUIPMENT AND OF HEALTH
OUTCOMES.
Not later than October 1, 2016, January 1, 2017, April 1, 2017, and
July 1, 2017, the Secretary of Health and Human Services shall publish
on the Internet website of the Centers for Medicare & Medicaid Services
the results of the monitoring of access of Medicare beneficiaries to
durable medical equipment and of health outcomes, as described on page
66228 in the final rule published by the Center for Medicare & Medicaid
Services on November 6, 2014, and entitled ``Medicare Program; End-
Stage Renal Disease Prospective Payment System, Quality Incentive
Program, and Durable Medical Equipment, Prosthetics, Orthotics, and
Supplies'' (79 Fed. Reg. 66120-66265).
SEC. 6. REVISION OF EFFECTIVE DATE OF PROVISION LIMITING FEDERAL
MEDICAID REIMBURSEMENT TO STATES FOR DURABLE MEDICAL
EQUIPMENT (DME) TO MEDICARE PAYMENT RATES.
(a) In General.--Section 1903(i)(27) of the Social Security Act (42
U.S.C. 1396b(i)(27)) is amended by striking ``January 1, 2019'' and
inserting ``October 1, 2018''.
(b) Effective Date.--The amendment made by subsection (a) shall
take effect as if included in the enactment of section 503 of division
O of Public Law 114-113.
Passed the Senate June 21, 2016.
Attest:
JULIE E. ADAMS,
Secretary.