II 110th CONGRESS 1st Session S. 1428 IN THE SENATE OF THE UNITED STATES May 17, 2007 Mr. Hatch (for himself, Mr. Conrad, and Mr. Roberts) introduced the following bill; which was read twice and referred to the Committee on Finance 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.

1.

Short title

This Act may be cited as the Medicare Durable Medical Equipment Access Act of 2007.

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).

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 suppliers that are classified as small businesses under the Small Business Act to continue to participate as suppliers at the single payment amount 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).