I
109th CONGRESS
1st Session
H. R. 3559
IN THE HOUSE OF REPRESENTATIVES
July 28, 2005
Mr. Hobson (for himself and Mr. Tanner) introduced the following bill; which was 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
A BILL
To amend part B of title XVIII of the Social Security Act to assure access to durable medical equipment under the Medicare Program.
Short title
This Act may be cited as the Medicare Durable Medical Equipment Access Act of 2005
.
Beneficiary protections
Application of quality standards
Section 1847(b)(2)(B) of the Social Security Act (42 U.S.C. 1395w–3(b)(2)(B)) is amended to read as follows:
Application of quality standards and receipt of advice from oversight committee
The Secretary may not award any contracts under the competitive acquisition program under this section unless—
the quality standards have been implemented under section 1834(a)(20); and
the Secretary has received advice from the program oversight committee established under subsection (c).
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Requiring use of exemptions
Section 1847(a)(3) of such Act (42 U.S.C. 1395w–3(a)(3)) is amended by striking may exempt
and inserting shall exempt
.
Exemption of smaller MSAs
Section 1847(a)(3)(A) of such Act (42 U.S.C. 1395w–3(a)(3)(A)) is amended by inserting (including any metropolitan statistical area with a population of less than 500,000)
after rural areas
.
Application of Federal Advisory Committee Act (FACA) to Program Advisory and Oversight Committee (PAOC)
Section 1847(c)(4) of such Act (42 U.S.C. 1395w–3(c)(4)) is amended to read as follows:
Applicability of faca
The provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee.
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Effective date
The amendments made by this section shall be effective as if included in the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173).
Small supplier protections
Qualified supplier participation
Section 1847(b) of the Social Security Act (42 U.S.C. 1395w–3(b)) is amended—
in paragraph (4)(A), by striking The Secretary may limit
and inserting Subject to paragraph (6)(D), the Secretary may limit
; and
in paragraph (6)(D), by adding at the end the following: Such appropriate steps shall include permitting suppliers that are classified as small businesses under the Small Business Act to continue to participate as suppliers at the selected award price so long as they submit bids at less than the fee schedule amount otherwise applicable to the items and they otherwise comply with applicable program requirements.
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Restoration of due process
Section 1847(b)(10) of such Act (42 U.S.C. 1395w–3(b)(10)) is amended—
by striking No administrative or judicial review
and inserting Restoration of appeal rights
; and
by striking There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of
and inserting Administrative and judicial review shall only be available under section 1869 (and not otherwise) of
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Application of requirement for significant savings
Section 1847(a) of such Act (42 U.S.C. 1395w–3(a)) is amended—
in paragraph (3)(B), by inserting of at least 10 percent
after significant savings
; and
in paragraph (1), by adding at the end the following new subparagraph:
Requirement for significant savings
The Secretary shall not implement a program under this section with respect to an item or service unless the Secretary demonstrates a probability of achieving significant savings of at least 10 percent, compared to the fee schedule in effect on January 1, 2006, by including the item or service in the program.
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Comparability analysis
Section 1834(a)(1) of such Act (42 U.S.C. 1395m(a)(1)) is amended—
in subparagraph (F), by inserting subject to subparagraph (G),
after 2009,
; and
by adding at the end the following new subparagraphs:
Requirement for comparability analysis before implementation
The Secretary may not implement subparagraph (F) with respect to the application of rates in an area that is not a competitive acquisition area under section 1847 unless the Secretary has completed and published in the Federal Register a comparability analysis to ensure the application is appropriate. The comparability analysis shall include at least an analysis of the relative costs of providing the particular items and services in the respective metropolitan statistical areas and an assessment of whether application of the bid rate in an area that is not a competitive acquisition area would adversely impact beneficiary access to quality items and services.
Application of comparability analysis requirement to certain other part B items and services
Subparagraph (G) shall also apply to the implementation of section 1847(a) with respect to items described in paragraph (2)(B) or (2)(C) of such section that are furnished on or after January 1, 2009.
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Effective date
The amendments made by this section shall be effective as if included in the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173).