To restore reimbursement for total body orthotic management for nonambulatory, severely disabled nursing home residents.

1. Adds SEC. ____. REIMBURSEMENT FOR TOTAL BODY ORTHOTIC MANAGEMENT FOR CERTAIN NURSING HOME PATIENTS at the end of subtitle B of title IV

   Adds a section

   In S. 1 · Reported to Senate

   (b) Report.--Not later than 1 year after the date of enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the study conducted under subsection (a). The report shall include recommendations regarding the use of more current data in computing geographic cost of practice indices as well as the use of data directly representative of physicians' costs (rather than proxy measures of such costs).

   Inserted: SEC. ____. REIMBURSEMENT FOR TOTAL BODY ORTHOTIC MANAGEMENT FOR CERTAIN NURSING HOME PATIENTS.

   Inserted: (a) In General.--Not later than 60 days after the date of the enactment of this Act, the Secretary shall issue product codes that qualified practioners and suppliers may use to receive reimbursement under section 1834(h) of the Social Security Act (42 U.S.C. 1395m(h)) for qualified total body orthotic management devices used for the treatment of nonambulatory individuals with severe musculoskeletal conditions who are in the full-time care of skilled nursing facilities (as defined in section 1861(j) of such Act (42 U.S.C. 1395x(j))). In issuing such codes, the Secretary shall take all steps necessary to prevent fraud and abuse.

   Inserted: (b) Qualified Total Body Orthotic Management Device.--For purposes of this section, the term "qualified total body orthotic management device" means a medically-prescribed device which--

   Inserted: (1) consists of custom fitted individual braces with adjustable points at the hips, knee, ankle, elbow, and wrist, but only if--

   Inserted: (A) the individually adjustable braces are attached to a frame which is an integral component of the device and cannot function or be used apart from the frame; and

   Inserted: (B) the frame is designed such that it serves no purpose without the braces; and

   Inserted: (2) is designed to--

   Inserted: (A) improve function;

   Inserted: (B) retard progression of musculoskeletal deformity; or

   Inserted: (C) restrict, eliminate, or assist in the functioning of lower and upper extremities and pelvic, spinal, and cervical regions of the body affected by injury, weakness, or deformity, of an individual for whom stabilization of affected areas of the body, or relief of pressure points, is required for medical reasons.

   Original wording

   At the end of subtitle B of title IV, add the following:

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As printed