[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 2736 Introduced in Senate (IS)]

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114th CONGRESS
  2d Session
                                S. 2736

      To improve access to durable medical equipment for Medicare 
   beneficiaries under the Medicare program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 17, 2016

   Mr. Thune (for himself, Ms. Heitkamp, Mr. Roberts, Mr. Crapo, Mr. 
    Rounds, Mrs. Capito, Mr. Grassley, Mr. Manchin, Mr. Daines, Mr. 
 Barrasso, Mr. Cochran, Ms. Hirono, Mr. Bennet, Mrs. Ernst, Mr. King, 
and Mr. Tester) introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
      To improve access to durable medical equipment for Medicare 
   beneficiaries 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 Durable Medical 
Equipment Act of 2016''.

SEC. 2. EXTENSION OF THE TRANSITION TO NEW PAYMENT RATES FOR DURABLE 
              MEDICAL EQUIPMENT UNDER THE MEDICARE PROGRAM.

    The Secretary of Health and Human Services shall extend the 
transition period described in clause (i) of section 414.210(g)(9) of 
title 42, Code of Federal Regulations, from June 30, 2016, to September 
30, 2017 (with the full implementation described in clause (ii) of such 
section applying to items and services furnished with dates of service 
on or after October 1, 2017).

SEC. 3. BID CEILING FOR COMPETITIVE ACQUISITION FOR DURABLE MEDICAL 
              EQUIPMENT UNDER THE MEDICARE PROGRAM.

    Section 1847(b)(5) of the Social Security Act (42 U.S.C. 1395w-
3(b)(5)) is amended--
            (1) in subparagraph (A)--
                    (A) by inserting ``, subject to subparagraph (E),'' 
                after ``subsection (a)(2)''; and
                    (B) by inserting ``, subject to subparagraph (E),'' 
                after ``Based on such bids''; and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Bid ceiling for durable medical equipment.--
                            ``(i) In general.--The ceiling for a bid 
                        submitted for applicable covered items may not 
                        be less than the fee schedule amount that would 
                        otherwise be determined for such items under 
                        section 1834(a), section 1834(h), or section 
                        1842(s)(1) on January 1, 2015, updated by the 
                        covered item update for such items under 
                        section 1834(a)(14)(L), section 1834(h), or 
                        section 1842(s)(1), respectively, as 
                        appropriate for the year with respect to which 
                        the bid ceiling is established for such 
                        applicable covered item.
                            ``(ii) Application to new covered items.--
                        The Secretary shall establish a process for 
                        purposes of applying clause (i) with respect to 
                        applicable covered items for which no fee 
                        schedule amount would otherwise be paid under 
                        section 1834(a), section 1834(h), or section 
                        1842(s), as appropriate, on January 1, 2015.
                            ``(iii) Applicable covered items defined.--
                        For purposes of this subparagraph, the term 
                        `applicable covered items' means competitively 
                        priced items and services described in 
                        subsection (a)(2) that are furnished with 
                        respect to rounds of competition that begin on 
                        or after January 1, 2017.''.

SEC. 4. REQUIREMENTS IN DETERMINING ADJUSTMENTS USING INFORMATION FROM 
              COMPETITIVE BIDDING PROGRAMS.

    Section 1834(a)(1)(G) of the Social Security Act (42 U.S.C. 
1395m(a)(1)(G)) is amended by adding at the end the following new 
sentence: ``In the case of items and services furnished on or after 
January 1, 2019, in making any adjustments under clause (ii) or (iii) 
of subparagraph (F), the Secretary shall--
                            ``(i) solicit and take into account 
                        stakeholder input; and
                            ``(ii) take into account the highest amount 
                        bid by a winning supplier in a competitive 
                        acquisition area and a comparison of each of 
                        the following with respect non-competitive 
                        acquisition areas and competitive acquisition 
                        areas:
                                    ``(I) The average travel distance 
                                and cost associated with furnishing 
                                items and services in the area.
                                    ``(II) Any barriers to access for 
                                items and services in the area.
                                    ``(III) The average delivery time 
                                in furnishing items and services in the 
                                area.
                                    ``(IV) The average volume of items 
                                and services furnished by suppliers in 
                                the area.
                                    ``(V) The number of suppliers in 
                                the area.''.

SEC. 5. MONTHLY REPORT ON THE RESULTS OF THE MONITORING OF ACCESS OF 
              MEDICARE BENEFICIARIES TO DURABLE MEDICAL EQUIPMENT AND 
              OF HEALTH OUTCOMES.

    Not later than the first of each month (beginning with May 1, 2016, 
and ending with September 1, 2017), the Secretary of Health and Human 
Services shall publish on the Internet website of the Centers for 
Medicare & Medicaid Services the results of the monitoring of access of 
Medicare beneficiaries to durable medical equipment and of health 
outcomes, as described on page 66228 in the final rule published by the 
Center for Medicare & Medicaid Services on November 6, 2014, and 
entitled ``Medicare Program; End-Stage Renal Disease Prospective 
Payment System, Quality Incentive Program, and Durable Medical 
Equipment, Prosthetics, Orthotics, and Supplies'' (79 Fed. Reg. 66120-
66265).

SEC. 6. REVISION OF EFFECTIVE DATE OF PROVISION LIMITING FEDERAL 
              MEDICAID REIMBURSEMENT TO STATES FOR DURABLE MEDICAL 
              EQUIPMENT (DME) TO MEDICARE PAYMENT RATES.

    (a) In General.--Section 1903(i)(27) of the Social Security Act (42 
U.S.C. 1396b(i)(27)) is amended by striking ``January 1, 2019'' and 
inserting ``October 1, 2018''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect as if included in the enactment of section 503 of division 
O of Public Law 114-113.
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