[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1845 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 1845

  To amend part B of title XVIII of the Social Security Act to assure 
    access to durable medical equipment under the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 29, 2007

   Mr. Tanner (for himself, Mr. Hobson, and Mr. Ross) 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.

    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 Durable Medical Equipment 
Access Act of 2007''.

SEC. 2. BENEFICIARY PROTECTIONS.

    (a) 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:
                    ``(B) 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--
                            ``(i) the quality standards have been 
                        implemented under section 1834(a)(20); and
                            ``(ii) the Secretary has received advice 
                        from the program oversight committee 
                        established under subsection (c).''.
    (b) 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''.
    (c) 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''.
    (d) 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:
            ``(4) Applicability of faca.--The provisions of the Federal 
        Advisory Committee Act (5 U.S.C. App.) shall apply to the 
        Committee.''.
    (e) 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).

SEC. 3. SMALL SUPPLIER PROTECTIONS.

    (a) Qualified Supplier Participation.--Section 1847(b) of the 
Social Security Act (42 U.S.C. 1395w-3(b)) is amended--
            (1) in paragraph (4)(A), by striking ``The Secretary may 
        limit'' and inserting ``Subject to paragraph (6)(D), the 
        Secretary may limit''; and
            (2) in paragraph (6)(D), by adding at the end the 
        following: ``Such appropriate steps shall include permitting 
        all suppliers 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.''.
    (b) Restoration of Due Process.--Section 1847(b)(10) of such Act 
(42 U.S.C. 1395w-3(b)(10)) is amended--
            (1) by striking ``No administrative or judicial review'' 
        and inserting ``Restoration of appeal rights''; and
            (2) 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''.
    (c) Application of Requirement for Significant Savings.--Section 
1847(a) of such Act (42 U.S.C. 1395w-3(a)) is amended--
            (1) in paragraph (3)(B), by inserting ``of at least 10 
        percent'' after ``significant savings''; and
            (2) in paragraph (1), by adding at the end the following 
        new subparagraph:
                    ``(D) 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, 2007, by 
                including the item or service in the program.''.
    (d) Comparability Analysis.--Section 1834(a)(1) of such Act (42 
U.S.C. 1395m(a)(1)) is amended--
            (1) in subparagraph (F), by inserting ``subject to 
        subparagraph (G),'' after ``2009,''; and
            (2) by adding at the end the following new subparagraphs:
                    ``(G) 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.
                    ``(H) 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.''.
    (e) 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).

SEC. 4. REPORT ON QUALITY AND ACCESS IMPACT OF IMPLEMENTATION AT 10 
              INITIAL COMPETITIVE ACQUISITION AREAS.

    (a) Analysis and Report.--After the Secretary of Health and Human 
Services has fully implemented the initial 10 competitive acquisition 
areas under section 1847 of the Social Security Act, the Secretary 
shall conduct a complete analysis of the impact of competitive bidding 
in those areas, including its impact on beneficiary access to quality 
products and its impact on providers of items and services covered 
under competition and shall submit a report to Congress on such 
analysis.
    (b) Moratorium on Further Implementation Until Congressional 
Action.--
            (1) In general.--Notwithstanding any other provision of 
        law, the Secretary shall not expand the coverage of competitive 
        acquisition programs under section 1847(a) of the Social 
        Security Act (42 U.S.C. 1395w-3(a)), or apply bid rates to non-
        bid areas under such section, beyond the 10 competitive 
        acquisition areas identified under paragraph (1)(B)(i)(I) of 
        such section as of the date of the enactment of this Act, 
        unless specifically authorized by Congress after such date.
            (2) Conforming reference.--Section 1847(a)(1)(B) of the 
        Social Security Act (42 U.S.C. 1395w-3(a)(1)(B)) is amended, in 
        the matter before clause (i), by striking ``The programs'' and 
        inserting ``Subject to section 4(b)(1) of the Medicare Durable 
        Medical Equipment Access Act of 2007, the programs''.
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