I 

109TH CONGRESS 

1ST SESSION H. R. 3559 

To amend part B of title XVIII of the Social Security Act to assure access 

to durable medical equipment under the Medicare Program. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 28, 2005 

Mr. HOBSON (for himself and Mr. TANNER) 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 part B of title XVIII of the Social Security 

Act to assure access to durable medical equipment under 

the Medicare Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Durable 

5 Medical Equipment Access Act of 2005’’. 
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1 SEC. 2. BENEFICIARY PROTECTIONS. 

2 (a) APPLICATION OF QUALITY STANDARDS.—Section 

3 1847(b)(2)(B) of the Social Security Act (42 U.S.C. 

4 1395w–3(b)(2)(B)) is amended to read as follows: 

5 ‘‘(B) APPLICATION OF QUALITY STAND6 ARDS AND RECEIPT OF ADVICE FROM OVER7 SIGHT COMMITTEE.—The Secretary may not 

8 award any contracts under the competitive ac9 quisition program under this section unless— 

10 ‘‘(i) the quality standards have been 

11 implemented under section 1834(a)(20); 

12 and 

13 ‘‘(ii) the Secretary has received advice 

14 from the program oversight committee es15 tablished under subsection (c).’’. 

16 (b) REQUIRING USE OF EXEMPTIONS.—Section 

17 1847(a)(3) of such Act (42 U.S.C. 1395w–3(a)(3)) is 

18 amended by striking ‘‘may exempt’’ and inserting ‘‘shall 

19 exempt’’. 

20 (c) EXEMPTION OF SMALLER MSAS.—Section 

21 1847(a)(3)(A) of such Act (42 U.S.C. 1395w–3(a)(3)(A)) 

22 is amended by inserting ‘‘(including any metropolitan sta23 tistical area with a population of less than 500,000)’’ after 

24 ‘‘rural areas’’. 

25 (d) APPLICATION OF FEDERAL ADVISORY COM26 MITTEE ACT (FACA) TO PROGRAM ADVISORY AND OVER-
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1 SIGHT COMMITTEE (PAOC).—Section 1847(c)(4) of such 

2 Act (42 U.S.C. 1395w–3(c)(4)) is amended to read as fol3 lows: 

4 ‘‘(4) APPLICABILITY OF FACA.—The provisions 

5 of the Federal Advisory Committee Act (5 U.S.C. 

6 App.) shall apply to the Committee.’’. 

7 (e) EFFECTIVE DATE.—The amendments made by 

8 this section shall be effective as if included in the enact9 ment of the Medicare Prescription Drug, Improvement, 

10 and Modernization Act of 2003 (Public Law 108–173). 

11 SEC. 3. SMALL SUPPLIER PROTECTIONS. 

12 (a) QUALIFIED SUPPLIER PARTICIPATION.—Section 

13 1847(b) of the Social Security Act (42 U.S.C. 1395w– 

14 3(b)) is amended— 

15 (1) in paragraph (4)(A), by striking ‘‘The Sec16 retary may limit’’ and inserting ‘‘Subject to para17 graph (6)(D), the Secretary may limit’’; and 

18 (2) in paragraph (6)(D), by adding at the end 

19 the following: ‘‘Such appropriate steps shall include 

20 permitting suppliers that are classified as small busi21 nesses under the Small Business Act to continue to 

22 participate as suppliers at the selected award price 

23 so long as they submit bids at less than the fee 

24 schedule amount otherwise applicable to the items 
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1 and they otherwise comply with applicable program 

2 requirements.’’. 

3 (b) RESTORATION OF DUE PROCESS.—Section 

4 1847(b)(10) of such Act (42 U.S.C. 1395w–3(b)(10)) is 

5 amended— 

6 (1) by striking ‘‘NO ADMINISTRATIVE OR JUDI7 CIAL REVIEW’’ and inserting ‘‘RESTORATION OF AP8 PEAL RIGHTS’’; and 

9 (2) by striking ‘‘There shall be no administra10 tive or judicial review under section 1869, section 

11 1878, or otherwise of’’ and inserting ‘‘Administra12 tive and judicial review shall only be available under 

13 section 1869 (and not otherwise) of’’. 

14 (c) APPLICATION OF REQUIREMENT FOR SIGNIFI15 CANT SAVINGS.—Section 1847(a) of such Act (42 U.S.C. 

16 1395w–3(a)) is amended— 

17 (1) in paragraph (3)(B), by inserting ‘‘of at 

18 least 10 percent’’ after ‘‘significant savings’’; and 

19 (2) in paragraph (1), by adding at the end the 

20 following new subparagraph: 

21 ‘‘(D) REQUIREMENT FOR SIGNIFICANT

22 SAVINGS.—The Secretary shall not implement a 

23 program under this section with respect to an 

24 item or service unless the Secretary dem25 onstrates a probability of achieving significant 
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1 savings of at least 10 percent, compared to the 

2 fee schedule in effect on January 1, 2006, by 

3 including the item or service in the program.’’. 

4 (d) COMPARABILITY ANALYSIS.—Section 1834(a)(1) 

5 of such Act (42 U.S.C. 1395m(a)(1)) is amended— 

6 (1) in subparagraph (F), by inserting ‘‘subject 

7 to subparagraph (G),’’ after ‘‘2009,’’; and 

8 (2) by adding at the end the following new sub9 paragraphs: 

10 ‘‘(G) REQUIREMENT FOR COMPARABILITY

11 ANALYSIS BEFORE IMPLEMENTATION.—The 

12 Secretary may not implement subparagraph (F) 

13 with respect to the application of rates in an 

14 area that is not a competitive acquisition area 

15 under section 1847 unless the Secretary has 

16 completed and published in the Federal Reg17 ister a comparability analysis to ensure the ap18 plication is appropriate. The comparability 

19 analysis shall include at least an analysis of the 

20 relative costs of providing the particular items 

21 and services in the respective metropolitan sta22 tistical areas and an assessment of whether ap23 plication of the bid rate in an area that is not 

24 a competitive acquisition area would adversely 
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1 impact beneficiary access to quality items and 

2 services. 

3 ‘‘(H) APPLICATION OF COMPARABILITY

4 ANALYSIS REQUIREMENT TO CERTAIN OTHER

5 PART B ITEMS AND SERVICES.—Subparagraph 

6 (G) shall also apply to the implementation of 

7 section 1847(a) with respect to items described 

8 in paragraph (2)(B) or (2)(C) of such section 

9 that are furnished on or after January 1, 

10 2009.’’. 

11 (e) EFFECTIVE DATE.—The amendments made by 

12 this section shall be effective as if included in the enact13 ment of the Medicare Prescription Drug, Improvement, 

14 and Modernization Act of 2003 (Public Law 108–173).

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