[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5808 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 5808

To amend title XVIII of the Social Security Act in order to strengthen 
 rules applied in case of competition for diabetic testing strips, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            December 8, 2014

 Ms. DeGette (for herself and Mr. Reed) 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 title XVIII of the Social Security Act in order to strengthen 
 rules applied in case of competition for diabetic testing strips, and 
                          for other purposes.

    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 ``Protecting Access to Diabetes 
Supplies of 2014''.

SEC. 2. STRENGTHENING RULES APPLIED IN CASE OF COMPETITION FOR DIABETIC 
              TESTING STRIPS.

    (a) Special Rule Applied in Case of Competition for Diabetic 
Testing Strips.--
            (1) In general.--Paragraph (10) of section 1847(b) of the 
        Social Security Act (42 U.S.C. 1395w-3(b)) is amended--
                    (A) in subparagraph (A), by striking the second 
                sentence and inserting the following new sentence: 
                ``The volume for such types of products shall be 
                determined through the use of multiple sources of data 
                that measure consumption and utilization of diabetic 
                testing strips among individuals in the United 
                States.''; and
                    (B) by adding at the end the following new 
                subparagraphs:
                    ``(C) Demonstration of ability to furnish types of 
                diabetic testing strips.--With respect to the program 
                described in subparagraph (A), the Secretary shall 
                reject a bid submitted by an entity if the entity does 
                not, as part of the demonstration to the Secretary 
                described in such subparagraph submitted by the entity, 
                demonstrate that the entity has an ability to furnish 
                the types of diabetic testing strips included in its 
                bid, including an ability to obtain and maintain an 
                inventory of such strips by volume in a manner 
                consistent with its bid.
                    ``(D) Use of unlisted types in calculation of 
                percentage.--In determining under subparagraph (A) 
                whether a bid submitted by an entity under such 
                subparagraph covers 50 percent (or such higher 
                percentage as the Secretary may specify) of all types 
                of diabetic testing strip products, the Secretary may 
                not attribute a percentage to types of diabetic testing 
                strips that the Secretary does not provide the entity 
                with the option to identify by type and market share 
                volume.
                    ``(E) Contract requirement.--Any contract entered 
                into with an entity for diabetic testing strips under 
                the competition conducted pursuant to paragraph (1) 
                shall include a requirement that the entity offers, 
                makes available to, and maintains in inventory of (or 
                otherwise has ready access to, such as through 
                purchasing contracts) each of the types of diabetic 
                testing strip products that is included in the bid 
                submitted by the entity. In the case that an entity 
                enters into such a contract with the Secretary and 
                fails to fulfill the requirement described in the 
                preceding sentence, the Secretary shall terminate such 
                contract.
                    ``(F) Monitoring adherence to demonstration.--The 
                Secretary shall establish a process to monitor, on an 
                ongoing basis, the extent to which an entity that 
                enters into a contract with the Secretary for diabetic 
                testing strips under the competition conducted pursuant 
                to paragraph (1) adheres to the demonstration that the 
                entity provided to the Secretary under subparagraph 
                (A).''.
            (2) Conforming amendment.--Section 1847(b)(3)(A) of the 
        Social Security Act (42 U.S.C. 1395w-3(b)(3)(A)) is amended by 
        adding at the end the following new sentence: ``In the case 
        that such a contract is for diabetic testing strips, such 
        contract shall include the information required under paragraph 
        (10)(E).''
    (b) Codifying and Expanding Anti-Switching Rule.--Section 1847(b) 
of the Social Security Act (42 U.S.C. 1395w-3(b)), as amended by 
subsection (a)(1), is further amended--
            (1) by redesignating paragraph (11) as paragraph (12); and
            (2) by inserting after paragraph (10) the following new 
        paragraph:
            ``(11) Additional special rule in case of competition for 
        diabetic testing strips.--
                    ``(A) In general.--With respect to diabetic testing 
                strips furnished by an entity to an individual under 
                the competitive acquisition program established under 
                this section, the entity shall furnish to the 
                individual the brand of such strips that is compatible 
                with the home blood glucose monitor selected by the 
                individual.
                    ``(B) Prohibition on influencing and 
                incentivizing.--An entity described in subparagraph (A) 
                may not attempt to influence or incentivize the 
                individual described in such subparagraph to switch the 
                brand of glucose monitor or testing strips selected by 
                the individual, including by--
                            ``(i) persuading, pressuring, or advising 
                        the individual to switch such brand; or
                            ``(ii) furnishing information about 
                        alternative brands to the individual in the 
                        case that the individual has not requested such 
                        information.
                    ``(C) Provision of information.--An entity 
                described in subparagraph (A) may not communicate 
                directly to an individual described in such 
                subparagraph until the entity has verbally provided the 
                individual with standardized information, to be 
                supplied to the entity by the Secretary, that describes 
                the rights of the individual with respect to the 
                entity. The information described in the preceding 
                sentence shall include information regarding--
                            ``(i) the requirements established in 
                        subparagraphs (A) and (B);
                            ``(ii) the right of the individual to 
                        contact other mail order suppliers of diabetic 
                        testing strips or to purchase such strips at a 
                        retail pharmacy in the case that the entity is 
                        not able to furnish the brand of such strips 
                        that is compatible with the home blood glucose 
                        monitor selected by the individual; and
                            ``(iii) the right of the individual 
                        described in subparagraph (D) to reject 
                        diabetic testing strips furnished to the 
                        individual by the entity.
                    ``(D) Individuals allowed to switch from unwanted 
                products.--
                            ``(i) In general.--The Secretary shall 
                        establish a process under which an individual 
                        furnished with diabetic testing strips under 
                        the competitive acquisition program established 
                        under this section may reject the strips by 
                        notification, including notification by 
                        telephone or electronic mail, to the supplier 
                        and to the Secretary.
                            ``(ii) Consequences of rejection.--In the 
                        case that an individual rejects diabetic 
                        testing strips under clause (i)--
                                    ``(I) any payment made to the 
                                supplier under this title for a portion 
                                of such strips furnished for use during 
                                the period beginning with the date on 
                                which the individual rejects the strips 
                                shall be recovered by the Secretary; 
                                and
                                    ``(II) the individual may obtain 
                                different diabetic testing strips from 
                                a supplier, and the Secretary shall 
                                process a claim for such different 
                                diabetic testing strips without regard 
                                to any benefit or coverage limitations 
                                arising from the fact that a claim has 
                                already been submitted and payment made 
                                for the rejected diabetic testing 
                                strips.
                            ``(iii) Prohibition on future claims.--In 
                        the case that an individual rejects diabetic 
                        testing strips under clause (i), the supplier 
                        who supplied the rejected diabetic testing 
                        strips to the individual may not submit 
                        additional claims for payment on behalf of the 
                        individual for the type or brand of diabetic 
                        testing strips so rejected by the individual, 
                        unless the individual makes a separate 
                        expression of consent to the supplier to be 
                        furnished with such type or brand of diabetic 
                        testing strips by the supplier.''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to diabetic testing strips furnished on or after 
July 1, 2016.
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