[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6639 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 6639

To amend title XVIII of the Social Security Act to provide for coverage 
   under the Medicare program of digital retinal imaging with remote 
                            interpretation.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 27, 2018

    Mr. Reed (for himself and Ms. Sewell of Alabama) 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 for coverage 
   under the Medicare program of digital retinal imaging with remote 
                            interpretation.

    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 ``Diabetic Vision Loss and Blindness 
Prevention Act of 2018''.

SEC. 2. MEDICARE COVERAGE OF DIGITAL RETINAL IMAGING WITH REMOTE 
              INTERPRETATION.

    (a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended--
            (1) in subsection (s)(2)--
                    (A) in subparagraph (FF), by striking ``and'' at 
                the end;
                    (B) in subparagraph (GG), by adding ``and'' at the 
                end; and
                    (C) by inserting after subparagraph (GG) the 
                following new subparagraph:
                    ``(HH) digital retinal imaging with remote 
                interpretation (as defined in subsection (jjj));''; and
            (2) by adding at the end the following new subsection:
    ``(jjj) Digital Retinal Imaging With Remote Interpretation.--The 
term `digital retinal imaging with remote interpretation' means an exam 
for the purpose of early detection or assessment of diabetic 
retinopathy that--
            ``(1) is provided not more frequently than on an annual 
        basis to an individual who has been diagnosed with diabetes and 
        who--
                    ``(A) does not have prior known diabetic 
                retinopathy; or
                    ``(B) is not known to have worse than mild non-
                proliferative diabetic retinopathy (ETDRS level 35);
            ``(2) is provided by or under the supervision of a primary 
        care practitioner (as defined in section 1833(x)) or board-
        certified endocrinologist;
            ``(3) utilizes a retinal camera with optical resolution 
        compliant with the International Organization for 
        Standardization ISO 10940 to take digital images of structures 
        behind the lens of the eye, such as the retina, choroid and 
        optic nerve; and
            ``(4) involves the electronic transmission of such images 
        for evaluation for diabetic retinopathy and other diseases of 
        the eye by a board-certified, State-licensed 
        ophthalmologist.''.
    (b) Payment.--Notwithstanding section 1834(m) of the Social 
Security Act (42 U.S.C. 1395m(m))--
            (1) payment shall be made pursuant to the amendments made 
        by subsection (a) for digital retinal imaging with remote 
        interpretation under CPT code 92250; and
            (2) the Secretary of Health and Human Services shall 
        establish a national minimum payment amount for CPT code 92250 
        and any successor to such codes that is not less than the 
        reimbursement rate in effect for such code (or predecessor 
        code) on December 31, 2017.
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