[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3053 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 3053

To ensure appropriate coverage of ventricular assist devices under the 
Medicare program under title XVIII of the Social Security Act, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 14, 2015

Mr. Bucshon (for himself, Mr. Boustany, and Ms. Clark of Massachusetts) 
 introduced the following bill; which was referred to the Committee on 
    Ways and Means, and in addition to the Committee on Energy and 
Commerce, 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 ensure appropriate coverage of ventricular assist devices under the 
Medicare program under title XVIII of the Social Security Act, 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 ``Medicare Ventricular Assist Device 
Access Act of 2015''.

SEC. 2. FINDINGS; PURPOSE.

    (a) Findings.--Congress finds the following:
            (1) Ventricular assistance devices are mechanical blood 
        pumps that surgeons attach to a damaged or weakened native 
        heart to assist in pumping blood.
            (2) Under its coverage policy as of the date of the 
        enactment of this Act, the Medicare program covers ventricular 
        assist devices for Medicare beneficiaries that meet certain 
        criteria after open-heart surgery, that are approved and listed 
        as candidates for heart transplant by a Medicare-approved heart 
        transplant center, and for those who are not eligible for a 
        heart transplant.
            (3) The Medicare program does not currently cover Medicare 
        beneficiaries for ventricular assist devices who are--
                    (A) undergoing an evaluation to determine their 
                candidacy for heart transplantation; or
                    (B) potential heart transplant candidates, but who 
                are currently not eligible for heart transplantation 
                because of a contraindication that may be favorably 
                modified by the use of a ventricular assist device.
            (4) Approximately 40 percent of patients who receive a 
        ventricular assist device are not eligible for a heart 
        transplant initially, but may become eligible as the 
        ventricular support improves their overall health.
    (b) Purpose.--The purpose of this Act is to ensure Medicare 
beneficiaries with heart failure have appropriate access to ventricular 
assist devices.

SEC. 3. REVISION OF MEDICARE VENTRICULAR ASSIST DEVICE NATIONAL 
              COVERAGE POLICY.

    (a) In General.--Notwithstanding section 1862(a)(1)(A) of the 
Social Security Act (42 U.S.C. 1395y(a)(1)(A)) or any other provision 
of law, the Secretary of Health and Human Services (in this section 
referred to as the ``Secretary'') shall revise the Medicare national 
coverage determination (as defined in section 1869(f)(1)(B) of the 
Social Security Act (42 U.S.C. 1395ff(f)(1)(B))) relating to coverage 
of ventricular assist devices to extend the coverage of such devices 
under title XVIII of the Social Security Act applied as of the date of 
the enactment of this Act with respect to individuals approved for 
heart transplantation to also apply to--
            (1) individuals who are undergoing an evaluation to 
        determine candidacy for heart transplantation; and
            (2) individuals who would be potential heart transplant 
        candidates, but are not so eligible because of a 
        contraindication that may be favorably modified by the use of a 
        ventricular assist device.
    (b) Construction.--Nothing in this section shall be construed--
            (1) to limit coverage of ventricular assist devices for 
        Medicare beneficiaries who meet the Medicare criteria for 
        coverage of ventricular assist devices as of the date of 
        enactment of this Act; or
            (2) as preventing the Secretary from expanding its coverage 
        decision beyond the coverage required under this section.
    (c) Revision of National Coverage Decision; Effective Date.--
            (1) Revision of national coverage decision.--The Secretary 
        shall use the processes described in section 1862(l) of the 
        Social Security Act (42 U.S.C. 1395y(l)) to revise its national 
        coverage determination relating to ventricular assist devices 
        to incorporate the requirements of this section.
            (2) Effective date.--The revised coverage decision 
        described in paragraph (1) shall apply to ventricular assist 
        devices furnished on or after the date that is 30 days after 
        the date of the enactment of this Act, regardless of the date 
        on which the Secretary completes the process required under 
        such paragraph.
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