[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2870 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 2870

To amend title XVIII of the Social Security Act to provide for coverage 
     of vision rehabilitation services under the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 15, 1999

   Mr. Capuano (for himself, Mr. Clay, Mr. Delahunt, Mr. Frost, Mr. 
 LaFalce, Ms. Lee, Mr. Gonzalez, Mr. McGovern, Mr. Moakley, Mr. Olver, 
   Mr. Pascrell, Ms. Pelosi, Mr. Tierney, Mr. Towns, and Mr. Weiner) 
 introduced the following bill; which was referred to the Committee on 
  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 title XVIII of the Social Security Act to provide for coverage 
     of vision rehabilitation services under the Medicare Program.

    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 ``Medicare Vision Rehabilitation 
Coverage Act of 1999''.

SEC. 2. MEDICARE COVERAGE OF VISION REHABILITATION SERVICES.

    (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)) is amended--
            (1) by striking ``and'' at the end of subparagraph (S);
            (2) by striking the period at the end of (T) and inserting 
        ``; and''; and
            (3) by adding at the end the following new subparagraph:
            ``(U) vision rehabilitation services (as defined in 
        subsection (uu)(1)).''.
    (b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x) 
is amended by adding at the end the following new subsection:

  ``Vision Rehabilitation Services; Vision Rehabilitation Professional

    ``(uu)(1) The term `vision rehabilitation services' means a program 
of restorative services (as determined by the Secretary in regulations) 
furnished by a vision rehabilitation professional (as defined in 
paragraph (2)) to an individual diagnosed with a vision impairment (as 
defined in paragraph (3)) to promote the independence of the individual 
notwithstanding such impairment, such services furnished pursuant to a 
plan of care established by a physician (as defined in paragraphs (1) 
or (4) of subsection (r)).
    ``(2) The term `vision rehabilitation professional' means an 
individual who--
            ``(A) is an orientation and mobility specialist or a 
        rehabilitation teacher;
            ``(B) holds a baccalaureate or higher degree granted by a 
        regionally accredited college or university in the United 
        States (or an equivalent foreign degree) in rehabilitation, 
        education, or related health field with a university-based 
        program of study and clinical experience in orientation and 
        mobility (as defined in paragraph (4)(A)) or rehabilitation 
        teaching (as defined in paragraph (4)(B)); and
            ``(C)(i) is licensed or certified as vision rehabilitation 
        professional by the State in which the services are performed; 
        or
            ``(ii) in the case of an individual in a State which does 
        not provide for such licensure or certification, is certified 
        by the Association for Education and Rehabilitation of the 
        Blind and Visually Impaired or meets such criteria as the 
        Secretary establishes in consultation with the following:
                    ``(I) The National Vision Rehabilitation 
                Cooperative.
                    ``(II) The Association for Education and 
                Rehabilitation of the Blind and Visually Impaired.
                    ``(III) National organizations representing 
                consumers and the elderly.
                    ``(IV) Such other organizations as the Secretary 
                determines appropriate.
    ``(3)(A) The term `vision impairment' means that an individual is 
blind or partially sighted.
    ``(B) The term `blind' means blind within the meaning of 
`blindness' as that term is defined in section 216(i)(1).
    ``(C) The term `partially sighted' means functional vision 
impairment that constitutes a significant limitation of visual 
capability resulting from disease, trauma, or congenital condition, 
that cannot be fully ameliorated by standard refractive correction, 
medication, or surgery, and that is manifested by one or more of the 
following:
            ``(i) Insufficient visual resolution.
            ``(ii) Inadequate field of vision.
            ``(iii) Reduced peak contrast sensitivity.
    ``(4)(A) The term `orientation and mobility' means the following 
services:
            ``(i) Assessment of needs of an individual who has a vision 
        impairment for skills training in methods of safe movement and 
        in strategies to gather required environmental and spatial 
        information.
            ``(ii) Development of appropriate integrated service plans 
        tailored to meet such needs identified pursuant to an 
        assessment under clause (i).
            ``(iii) Provision of training in and utilization of--
                    ``(I) equipment and adaptive devices intended and 
                designed for use by such an individual; and
                    ``(II) specialized techniques adapted for such 
                individuals, including orientation, sensory 
                development, systems of safe movement (including long 
                cane techniques), resource identification, professional 
                referrals (as appropriate), and, in applied settings 
                reinforcing instruction for the use of optical devices 
                as prescribed by optometrists and ophthalmologists.
            ``(iv) Evaluation of such an individual receiving training 
        under clause (iii).
    ``(B) The term `rehabilitation teaching' means the following 
services:
            ``(i) Assessment of needs of an individual with a vision 
        impairment for skills training in independent living and 
        communications.
            ``(ii) Development of appropriate integrated service plans 
        tailored to meet such needs identified pursuant to an 
        assessment under clause (i).
            ``(iii) Provision of training in, and utilization of--
                    ``(I) equipment and adaptive devices intended and 
                designed for use by such an individual, including, in 
                applied settings, reinforcing instruction for the use 
                of optical devices as prescribed by optometrists or 
                ophthalmologists; and
                    ``(II) specialized techniques adapted such an 
                individual, including braille and other communication 
                skills, problem solving skills, resource management, 
                and professional referrals (as appropriate).
            ``(iv) Evaluation of such an individual receiving training 
        under clause (iii).''.
    (c) Payment.--Section 1833(a)(1) of such Act (42 U.S.C. 
1395l(a)(1)) is amended--
            (1) by striking ``and'' before ``(S)''; and
            (2) by inserting before the semicolon at the end the 
        following: ``, and (T) with respect to vision rehabilitation 
        services (as defined in section 1861(uu)) furnished by a vision 
        rehabilitation professional, the amount paid shall be 80 
        percent of the lesser of the actual charge for the services or 
        85 percent of the amount determined under the fee schedule 
        established under section 1848(b) for the same services if 
        furnished by a physician''.
    (d) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after the date of the enactment of 
this Act.
    (e) Consultation.--The Secretary shall consult with the National 
Vision Rehabilitation Cooperative, the Association for Education and 
Rehabilitation of the Blind and Visually Impaired, and such other 
qualified professional organizations as the Secretary determines 
appropriate in promulgating regulations to carry out this Act.
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