[Congressional Record Volume 162, Number 99 (Tuesday, June 21, 2016)]
[Senate]
[Pages S4427-S4428]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 4853. Mr. McCONNELL (for Mr. Thune) proposed an amendment to the
bill S. 2736, to improve access to durable medical equipment for
Medicare beneficiaries under the Medicare program, and for other
purposes; as follows:
Strike all after the enacting clause and insert the
following:
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 June 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 July
1, 2017).
SEC. 3. FLOOR ON 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) Floor on 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 under
section 1834(a), section 1834(h), or section 1842(s) for such
items furnished on July 1, 2016 (determined as if section 2
of the Patient Access to Durable Medical Equipment Act of
2016 had not been enacted).
``(ii) 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.
(a) In General.--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), under subsection (h)(1)(H)(ii), or under section
1842(s)(3)(B), 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 to 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.''.
(b) Conforming Amendments.--(1) Section 1834(h)(1)(H)(ii)
of the Social Security Act (42 U.S.C. 1395m(h)(1)(H)(ii)) is
amended by striking ``the Secretary'' and inserting ``subject
to subsection (a)(1)(G), the Secretary''.
(2) Section 1842(s)(3)(B) of the Social Security Act (42
U.S.C. 1395m(s)(3)(B)) is amended by striking ``the
Secretary'' and inserting ``subject to section 1834(a)(1)(G),
the Secretary''.
SEC. 5. REPORTS ON THE RESULTS OF THE MONITORING OF ACCESS OF
MEDICARE BENEFICIARIES TO DURABLE MEDICAL
EQUIPMENT AND OF HEALTH OUTCOMES.
Not later than October 1, 2016, January 1, 2017, April 1,
2017, and July 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
[[Page S4428]]
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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