[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3977 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 3977

      To amend title XVIII of the Social Security Act to protect 
    beneficiaries with limb loss and other orthopedic conditions by 
  providing access to appropriate, safe, effective, patient-centered 
 orthotic and prosthetic care; to reduce fraud, waste, and abuse with 
     respect to orthotics and prosthetics, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 19, 2024

  Mr. Warner (for himself, Mr. Daines, Ms. Klobuchar, and Mr. Cornyn) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
      To amend title XVIII of the Social Security Act to protect 
    beneficiaries with limb loss and other orthopedic conditions by 
  providing access to appropriate, safe, effective, patient-centered 
 orthotic and prosthetic care; to reduce fraud, waste, and abuse with 
     respect to orthotics and prosthetics, 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 Orthotics and Prosthetics 
Patient-Centered Care Act''.

SEC. 2. INCREASING PROTECTIONS FOR MEDICARE BENEFICIARIES RECEIVING 
              ORTHOTIC AND PROSTHETIC CARE.

    (a) Prohibition on Payment for Items Delivered by Drop Shipment.--
            (1) In general.--Section 1834(h)(1) of the Social Security 
        Act (42 U.S.C. 1395m(h)(1)) is amended by adding at the end the 
        following new subparagraph:
                    ``(I) Prohibition on payment for certain items 
                furnished using a drop shipment.--
                            ``(i) In general.--No payment shall be made 
                        under this subsection for an item described in 
                        clause (ii) furnished to an individual via a 
                        drop shipment.
                            ``(ii) Items described.--This items 
                        described in this clause are the following:
                                    ``(I) A prosthesis (as defined in 
                                paragraph (4)(C)), except that such 
                                term does not include supplies for such 
                                prosthesis.
                                    ``(II) A custom-fabricated orthosis 
                                (as described in subparagraph (F)(ii)), 
                                or a custom-fitted orthosis, except 
                                that such term does not include 
                                supplies for such orthosis.
                                    ``(III) Off-the-shelf orthotics (as 
                                defined in section 1847(a)(2)(C)) that 
                                are not otherwise subject to 
                                competitive bidding and are delivered 
                                by drop shipment.
                            ``(iii) Drop shipment defined.--In this 
                        subparagraph, the term `drop shipment' means 
                        the direct shipment of a prosthesis or an 
                        orthosis to an individual that has not received 
                        training or education with respect to fitting 
                        and adjustment or training in the care and use 
                        of such prosthesis or orthosis from a qualified 
                        practitioner (as described in subparagraph 
                        (F)(iii)).''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to items furnished on or after the first day of the 
        first full calendar year following the date of enactment of 
        this Act.
    (b) Additional Practitioners Exempt From Competitive Acquisition.--
Section 1847(a)(7)(A)(i) of the Social Security Act (42 U.S.C. 1395w-
3(a)(7)(A)(i)) is amended--
            (1) by inserting ``, physical therapist, occupational 
        therapist, orthotist, prosthetist'' after ``by a physician''; 
        and
            (2) by inserting ``, physical therapist, occupational 
        therapist, orthotist, prosthetist'' after ``the physician's'' 
        in each place such term occurs.
    (c) Ensuring Beneficiary Access to Replacement Custom-Fitted 
Orthotic Devices and Custom-Fabricated Orthotic Devices.--Section 
1834(h)(1)(G) of the Social Security Act (42 U.S.C. 1395m(h)(1)(G)) is 
amended--
            (1) in the heading, by inserting ``, custom-fitted orthotic 
        devices, custom-fabricated orthotic devices,'' after 
        ``Replacement of prosthetic devices''; and
            (2) in clause (i), by inserting ``, replacement of custom-
        fitted orthotic devices, replacement of custom-fabricated 
        orthotic devices,'' after ``which are artificial limbs,''.
    (d) Updating Definitions of Orthotics and Prosthetics.--Section 
1834(h)(4)(C) of the Social Security Act (42 U.S.C. 1395m(h)(4)(C)) is 
amended by striking ``the term `orthotics and prosthetics' has the 
meaning given such term'', and inserting ``the terms `orthotics and 
prosthetics' and `orthoses and prostheses' have the meaning given such 
terms''.
    (e) Regulations.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
promulgate final regulations to implement the amendments made by this 
Act.
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