[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1018 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 1018

To amend title XVIII of the Social Security Act to provide coverage of 
certain disposable medical technologies under the Medicare program, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 20, 2015

Mrs. Ellmers of North Carolina (for herself, Mr. Butterfield, and Mrs. 
  Blackburn) 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 to provide coverage of 
certain disposable medical technologies under the Medicare program, 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 ``Patient Access to Disposable Medical 
Technology Act of 2015''.

SEC. 2. COVERAGE OF CERTAIN DISPOSABLE MEDICAL TECHNOLOGIES UNDER THE 
              MEDICARE PROGRAM.

    (a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended by adding at the end the following new subsection:

               ``Substitute Disposable Medical Technology

    ``(iii) The term `substitute disposable medical technology' means 
medical equipment that--
            ``(1) is primarily and customarily used to serve a medical 
        purpose;
            ``(2) would otherwise be covered as durable medical 
        equipment under this title but for the fact that such equipment 
        is not durable (as defined by the Secretary for purposes of 
        coverage of durable medical equipment under this title); and
            ``(3) the Secretary determines substitutes for durable 
        medical equipment.''.
    (b) Payment Provisions.--Section 1834(a) of the Social Security Act 
(42 U.S.C. 1395m(a)) is amended by adding at the end the following new 
paragraph:
            ``(23) Special payment rule for substitute disposable 
        medical technologies.--Notwithstanding the preceding provisions 
        of this subsection, the Secretary shall determine the payment 
        amount under this subsection for a substitute disposable 
        medical technology (as defined in section 1861(iii)), and for 
        any services and supplies used in conjunction with such 
        technology, in accordance with the following:
                    ``(A) Single payment amount.--The Secretary shall 
                determine a single payment amount that shall be paid 
                for a substitute disposable medical technology and for 
                any services and supplies used in conjunction with such 
                technology. A payment for such a technology and for any 
                such services and supplies that is made in the amount 
                of such single payment amount shall constitute full 
                payment under this title for such technology and such 
                services and supplies.
                    ``(B) Calculation of payment amount.--The single 
                payment amount described in subparagraph (A) for a 
                substitute disposable medical technology and for any 
                services and supplies used in conjunction with such 
                technology shall be calculated by--
                            ``(i) calculating the sum of the amounts of 
                        payment that otherwise would be made under this 
                        section for--
                                    ``(I) the item of durable medical 
                                equipment for which the Secretary 
                                determines, pursuant to section 
                                1861(iii)(3), that such substitute 
                                disposable medical technology 
                                substitutes; and
                                    ``(II) all services and supplies 
                                used in conjunction with such item of 
                                durable medical equipment;
                            ``(ii) calculating the amount that is 95 
                        percent of the sum calculated under clause (i); 
                        and
                            ``(iii) calculating the single payment 
                        amount for the substitute disposable medical 
                        technology and for any services and supplies 
                        used in conjunction with such technology such 
                        that the sum of the payments under this 
                        subsection for--
                                    ``(I) all substitute disposable 
                                medical technologies that the Secretary 
                                determines, pursuant to section 
                                1861(iii)(3), will be necessary to 
                                provide a substitute for the item of 
                                durable medical equipment described in 
                                clause (i)(I); and
                                    ``(II) any services and supplies 
                                used in conjunction with such 
                                technologies;
                        is equal to the amount calculated under clause 
                        (ii).
                    ``(C) Lump-sum payment.--The single payment amount 
                described in subparagraph (A) for a substitute 
                disposable medical technology and for any services and 
                supplies used in conjunction with such technology shall 
                be made in a lump-sum amount.''.
    (c) Nonapplication of Competitive Acquisition.--Section 
1847(a)(7)(B) of the Social Security Act (42 U.S.C. 1395w-3(a)(7)(B)) 
is amended--
            (1) in clause (i), by striking ``and'' at the end;
            (2) in clause (ii), by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following new clause:
                            ``(iii) that are substitute disposable 
                        medical technologies (as defined in section 
                        1861(n)(2)(B)).''.
    (d) Effective Date.--The amendments made by this section shall 
apply with respect to items and services furnished on or after the date 
that is one year after the date of the enactment of this section.
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