[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4665 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 4665
To amend title XVIII of the Social Security Act to provide coverage for
certain vision items and services under part B of the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 11, 2019
Ms. Schrier (for herself, Mr. O'Halleran, Ms. Slotkin, and Ms. DelBene)
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 for
certain vision items and services under part B of the Medicare program.
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 Vision Act of 2019''.
SEC. 2. PROVIDING COVERAGE FOR VISION CARE UNDER THE MEDICARE PROGRAM.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (GG), by striking ``and'' after the
semicolon at the end;
(2) in subparagraph (HH), by striking the period at the end
and adding ``; and''; and
(3) by adding at the end the following new subparagraph:
``(II) vision services (as defined in subsection (kkk));''.
(b) Vision Services Defined.--Section 1861 of the Social Security
Act (42 U.S.C. 1395x) is amended by adding at the end the following new
subsection:
``(kkk) Vision Services.--The term `vision services' means--
``(1) routine eye examinations, including procedures
performed during the course of such examination to determine
the refractive state of the eyes; and
``(2) contact lens fitting services,
furnished on or after January 1, 2022, by or under the direct
supervision of an optometrist or ophthalmologist who is legally
authorized to furnish such examinations, procedures, or fitting
services (as applicable) under State law (or the State regulatory
mechanism provided by State law) of the State in which the
examinations, procedures, or fitting services are furnished.''.
(c) Payment; Coinsurance; and Limitations.--
(1) In general.--Section 1833(a)(1) of the Social Security
Act (42 U.S.C. 1395l(a)(1)) is amended--
(A) by striking ``and'' before ``(CC)''; and
(B) by inserting before the semicolon at the end
the following: ``, and (DD) with respect to vision
services (as defined in section 1861(kkk)), the amount
paid shall be equal to 80 percent of the lesser of the
actual charge or the amount determined under the
payment basis determined under section 1848''.
(2) Limits specified.--Section 1834 of the Social Security
Act (42 U.S.C. 1395m) is amended by adding at the end the
following new subsection:
``(x) Limitation for Vision Services.--With respect to vision
services (as defined in section 1861(kkk)) and an individual, payment
may be made under this part for only 1 routine eye examination
described in paragraph (1) of such section and 1 contact lens fitting
service described in paragraph (2) of such section during a 2-year
period.''.
(d) Payment Under Physician Fee Schedule.--
(1) In general.--Section 1848(j)(3) of the Social Security
Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting
``(2)(II),'' before ``(3)''.
(2) Budget neutrality.--Section 1848(c)(2)(B)(iv) of the
Social Security Act (42 U.S.C. 1395-w(c)(2)(B)(iv)) is
amended--
(A) in subclause (III), by striking ``and'' at the
end;
(B) in subclause (IV), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following new
subclause:
``(V) the amendment made by section
2(d)(1) of the Medicare Vision Act of
2019 shall not be taken into account in
applying clause (ii)(II) for 2022 and
2023.''.
(e) Coverage of Conventional Eyeglasses and Contact Lenses.--
Section 1861(s)(8) of the Social Security Act (42 U.S.C. 1395x(s)(8))
is amended by striking ``, and including one pair of conventional
eyeglasses or contact lenses furnished subsequent to each cataract
surgery with insertion of an intraocular lens'' and inserting ``,
including one pair of conventional eyeglasses or contact lenses
furnished subsequent to each cataract surgery with insertion of an
intraocular lens, if furnished before January 1, 2022, and including
conventional eyeglasses or contact lenses, whether or not furnished
subsequent to such a surgery, if furnished on or after January 1,
2022''.
(f) Special Payment Rules for Eyeglasses and Contact Lenses.--
(1) Limitations.--Section 1834(h) of the Social Security
Act (42 U.S.C. 1395m(h)) is amended by adding at the end the
following new paragraph:
``(6) Payment limitations for eyeglasses and contact
lenses.--With respect to eyeglasses and contact lenses
furnished to an individual on or after January 1, 2022, payment
may be made under this part only--
``(A) during any 2-year period, for either 1 pair
of eyeglasses (including lenses and frames) or a 2-year
supply that is provided in not more than 180-day
increments of contact lenses;
``(B) with respect to amounts attributable to the
frames of such a pair of eyeglasses and amounts
attributable to contact lenses furnished during a year,
in an amount not greater than--
``(i) for 2022, $100; and
``(ii) for a subsequent year, the amount
specified under this subparagraph for the
previous year, increased by the percentage
change in the Consumer Price Index for All
Urban Consumers during such previous year;
``(C) for types of eyeglass lenses, and for types
of contact lenses, as determined appropriate by the
Secretary; and
``(D) if furnished pursuant to a written order of a
physician described in section 1861(kkk).''.
(2) Application of competitive acquisition.--
(A) In general.--Section 1834(h)(1)(H) of the
Social Security Act (42 U.S.C. 1395m(h)(1)(H)) is
amended--
(i) in the header by inserting ``,
eyeglasses, and contact lenses'' after
``orthotics'';
(ii) by inserting ``and of eyeglasses and
contact lenses described in paragraph (2)(D) of
such section,'' after ``2009,''; and
(iii) in clause (i), by inserting ``or such
eyeglasses and contact lenses'' after
``orthotics''.
(B) Conforming amendment.--
(i) In general.--Section 1847(a)(2) of the
Social Security Act (42 U.S.C. 1395w-3(a)(2))
is amended by adding at the end the following
new subparagraph:
``(D) Eyeglasses and contact lenses.--Eyeglasses
and contact lenses for which payment would otherwise be
made under section 1834(h).''.
(ii) Exemption of certain items from
competitive acquisition.--Section 1847(a)(7) of
the Social Security Act (42 U.S.C. 1395w-
3(a)(7)) is amended by adding at the end the
following new subparagraph:
``(C) Certain eyeglasses and contact lenses.--Those
items and services described in paragraph (2)(D) if
furnished by a physician or other practitioner (as
defined by the Secretary) to the physician's or
practitioner's own patients as part of the physician's
or practitioner's professional service.''.
(g) Exclusion Modifications.--Section 1862(a) of the Social
Security Act (42 U.S.C. 1395y(a)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (O), by striking ``and'' at the
end;
(B) in subparagraph (P), by striking the semicolon
at the end and inserting ``, and''; and
(C) by adding at the end the following new
subparagraph:
``(Q) in the case of vision services (as defined in section
1861(kkk)) that are routine eye examinations and contact lens
fitting services (as described in paragraph (1) or (2),
respectively, of such section), which are furnished more
frequently than once during a 2-year period;''; and
(2) in paragraph (7)--
(A) by inserting ``(other than such an examination
that is a vision service that is covered under section
1861(s)(2)(II))'' after ``eye examinations''; and
(B) by inserting ``(other than such a procedure
that is a vision service that is covered under section
1861(s)(2)(II))'' after ``refractive state of the
eyes''.
SEC. 3. IMPLEMENTATION FUNDING.
The Secretary of Health and Human Services shall provide for the
transfer from the Federal Supplementary Medical Insurance Trust Fund
under section 1841 of the Social Security Act (42 U.S.C. 1395t) to the
Centers for Medicare & Medicaid Services Program Management Account for
the period of 2020 through 2024 of such sums as may be necessary for
purposes of implementing the amendments made by section 2.
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