I 

118TH CONGRESS 

1ST SESSION H. R. 1326 

To modify the limitation on the deduction by individuals of certain State 

and local taxes and to provide coverage for hearing and vision care 

under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 1, 2023 

Ms. PORTER introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, 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 modify the limitation on the deduction by individuals 

of certain State and local taxes and to provide coverage 

for hearing and vision care 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 ‘‘Supporting Americans 

5 with Lower Taxes Act’’ or as the ‘‘SALT Act’’. 


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1 SEC. 2. MODIFICATION OF LIMITATION ON THE DEDUC2 TION BY INDIVIDUALS OF CERTAIN STATE 

3 AND LOCAL, ETC., TAXES. 

4 (a) IN GENERAL.—Section 164(b)(6) of the Internal 

5 Revenue Code of 1986 is amended to read as follows: 

6 ‘‘(6) LIMITATION ON DEDUCTION BY CERTAIN

7 HIGH-INCOME INDIVIDUALS.— 

8 ‘‘(A) IN GENERAL.—In the case of a tax9 payer with adjusted gross income which equals 

10 or exceeds $400,000 for any taxable year— 

11 ‘‘(i) foreign real property taxes shall 

12 not be taken into account under subsection 

13 (a)(1) (or section 216(a)) for such taxable 

14 year, and 

15 ‘‘(ii) the aggregate amount of taxes 

16 taken into account under paragraphs (1), 

17 (2), and (3) of subsection (a) and para18 graph (5) of this subsection (and any tax 

19 described in any such paragraph taken into 

20 account under section 216(a)(1)) for such 

21 taxable year shall not exceed $60,000. 

22 ‘‘(B) PHASEDOWN OF LIMITATION BASED

23 ON ADJUSTED GROSS INCOME.—The $60,000 

24 amount in subparagraph (A)(ii) shall be re25 duced (but not below zero) by the dollar 


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1 amount which bears the same ratio to $60,000 

2 as— 

3 ‘‘(i) the excess of the taxpayer’s ad4 justed gross income over $400,000, bears 

5 to 

6 ‘‘(ii) $600,000. 

7 ‘‘(C) APPLICATION RESTRICTED TO CER8 TAIN TAXPAYERS AND TAXES.— 

9 ‘‘(i) APPLICATION TO INDIVIDUALS.— 

10 Subparagraph (A) shall only apply to indi11 viduals, estates, and trusts. 

12 ‘‘(ii) EXCLUSION OF CERTAIN BUSI13 NESS TAXES.—Subparagraph (A) shall not 

14 apply to any foreign taxes described in 

15 subsection (a)(3) or to any taxes described 

16 in paragraph (1) and (2) of subsection (a) 

17 which are paid or accrued in carrying on 

18 a trade or business or an activity described 

19 in section 212. 

20 ‘‘(D) MARRIED INDIVIDUALS FILING A

21 SEPARATE RETURN.—In the case of a married 

22 individual filing a separate return, subpara23 graphs (A) and (B) shall be applied— 

24 ‘‘(i) by substituting ‘$200,000’ for 

25 ‘$400,000’ each place it appears, 


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1 ‘‘(ii) by substituting ‘$30,000’ for 

2 ‘$60,000’ each place it appears, and 

3 ‘‘(iii) by substituting ‘$300,000’ for 

4 ‘$600,000’ in subparagraph (B)(ii). 

5 ‘‘(E) ESTATES AND TRUSTS.—In the case 

6 of an estate or trust, adjusted gross income 

7 shall be determined as provided in section 

8 67(e). 

9 ‘‘(F) DENIAL OF DEDUCTION TO BILLION10 AIRES.—Unless the taxpayer has less than 

11 $1,000,000,000 ($500,000,000 in the case of a 

12 married individual filing a separate return) in 

13 assets as of the close of the taxable year (and 

14 attests to such fact under penalty of perjury at 

15 such time and in such manner as the Secretary 

16 may provide)— 

17 ‘‘(i) subparagraph (A) shall be ap18 plied— 

19 ‘‘(I) by substituting ‘zero’ for 

20 ‘$400,000’, and 

21 ‘‘(II) by substituting ‘zero’ for 

22 ‘$60,000’, and 

23 ‘‘(ii) subparagraphs (B) and (D) shall 

24 not apply. 


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1 For purposes of this subparagraph, the term 

2 ‘assets’ means all property, real or personal, 

3 tangible or intangible, wherever situated (within 

4 the meaning of section 2031) and such property 

5 shall be valued in the same manner as for pur6 poses of part III of subchapter A of chapter 

7 11.’’. 

8 (b) EFFECTIVE DATE.—The amendment made by 

9 subsection (a) shall apply to taxable years beginning after 

10 the date of the enactment of this Act. 

11 (c) APPROPRIATIONS TO FEDERAL SUPPLEMENTARY

12 MEDICAL INSURANCE TRUST FUND.— 

13 (1) IN GENERAL.—There are hereby appro14 priated to the Federal Supplementary Medical Insur15 ance Trust Fund amounts equivalent to the amounts 

16 received in the Treasury by reason of the amend17 ment made by subsection (a). Rules similar to the 

18 rules of section 9601 of the Internal Revenue Code 

19 of 1986 shall apply with respect to transfers made 

20 by reason of the preceding sentence. 

21 (2) CONFORMING AMENDMENT.—Section 

22 1841(a) of the Social Security Act (42 U.S.C. 

23 1395t) is amended by inserting ‘‘, or section 2(b) of 

24 the SALT Act,’’ after ‘‘this part’’. 


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1 SEC. 3. PROVIDING COVERAGE FOR HEARING CARE UNDER 

2 THE MEDICARE PROGRAM. 

3 (a) PROVISION OF AUDIOLOGY SERVICES BY QUALI4 FIED AUDIOLOGISTS AND QUALIFIED HEARING AID PRO5 FESSIONALS.— 

6 (1) IN GENERAL.—Section 1861(ll) of the So7 cial Security Act (42 U.S.C. 1395x(ll)) is amend8 ed— 

9 (A) in paragraph (3)— 

10 (i) by inserting ‘‘(and, beginning Jan11 uary 1, 2025, such aural rehabilitation and 

12 treatment services)’’ after ‘‘assessment 

13 services’’; 

14 (ii) by inserting ‘‘, and, beginning on 

15 January 1, 2025, such hearing assessment 

16 services furnished by a qualified hearing 

17 aid professional,’’ after ‘‘by a qualified au18 diologist’’; and 

19 (iii) by striking ‘‘the audiologist’’ and 

20 inserting ‘‘the audiologist or qualified hear21 ing aid professional’’; and 

22 (B) in paragraph (4), by adding at the end 

23 the following new subparagraph: 

24 ‘‘(C) The term ‘qualified hearing aid profes25 sional’ means, with respect to hearing assessment 


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1 services described in paragraph (3), an individual 

2 who— 

3 ‘‘(i) is licensed or registered as a hearing 

4 aid dispenser, hearing aid specialist, hearing in5 strument dispenser, or related professional by 

6 the State in which the individual furnishes such 

7 services; and 

8 ‘‘(ii) meets such other requirements as the 

9 Secretary determines appropriate (including re10 quirements relating to educational certifications 

11 or accreditations), taking into account any addi12 tional requirements for hearing aid specialists, 

13 hearing aid dispensers, and hearing instrument 

14 dispensers established by Medicare Advantage 

15 organizations under part C, State plans (or 

16 waivers of such plans) under title XIX, and the 

17 group health plans and health insurance issuers 

18 (as such terms are defined in section 2791 of 

19 the Public Health Service Act).’’. 

20 (2) PAYMENT FOR QUALIFIED HEARING AID

21 PROFESSIONALS.—Section 1833(a)(1) of the Social 

22 Security Act (42 U.S.C. 1395l(a)(1)) is amended— 

23 (A) by striking ‘‘and’’ before ‘‘(HH)’’; and 

24 (B) by inserting before the semicolon at 

25 the end the following: ‘‘and (II) with respect to 


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1 hearing assessment services (as described in 

2 paragraph (3) of section 1861(ll)) furnished by 

3 a qualified hearing aid professional (as defined 

4 in paragraph (4)(C) of such section), the 

5 amounts paid shall be equal to 80 percent of 

6 the lesser of the actual charge for such services 

7 or 85 percent of the amount for such services 

8 determined under the payment basis determined 

9 under section 1848’’. 

10 (b) COVERAGE OF HEARING AIDS.— 

11 (1) INCLUSION OF HEARING AIDS AS PROS12 THETIC DEVICES.—Section 1861(s)(8) of the Social 

13 Security Act (42 U.S.C. 1395x(s)(8)) is amended by 

14 inserting ‘‘, and including hearing aids (as described 

15 in section 1834(h)(7)) furnished on or after January 

16 1, 2025, to individuals diagnosed with moderately 

17 severe, severe, or profound hearing loss’’ before the 

18 semicolon at the end. 

19 (2) PAYMENT LIMITATIONS FOR HEARING

20 AIDS.—Section 1834(h) of the Social Security Act 

21 (42 U.S.C. 1395m(h)) is amended by adding at the 

22 end the following new paragraphs: 

23 ‘‘(6) PAYMENT ONLY ON AN ASSIGNMENT-RE24 LATED BASIS.—Payment for hearing aids for which 

25 payment may be made under this part may be made 


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1 only on an assignment-related basis. The provisions 

2 of section 1842(b)(18)(B) shall apply to hearing aids 

3 in the same manner as they apply to services fur4 nished by a practitioner described in subsection 

5 (b)(18)(C). 

6 ‘‘(7) LIMITATIONS FOR HEARING AIDS.—Pay7 ment may be made under this part with respect to 

8 an individual, with respect to hearing aids furnished 

9 on or after January 1, 2025— 

10 ‘‘(A) not more than once per ear during a 

11 5-year period; 

12 ‘‘(B) only for types of such hearing aids 

13 that are determined appropriate by the Sec14 retary; and 

15 ‘‘(C) only if furnished pursuant to a writ16 ten order of a physician, qualified audiologist 

17 (as defined in section 1861(ll)(4)), qualified 

18 hearing aid professional (as so defined), physi19 cian assistant, nurse practitioner, or clinical 

20 nurse specialist.’’. 

21 (3) APPLICATION OF COMPETITIVE ACQUISI22 TION.— 

23 (A) IN GENERAL.—Section 1834(h)(1)(H) 

24 of the Social Security Act (42 U.S.C. 

25 1395m(h)(1)(H)) is amended— 


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1 (i) in the header, by inserting ‘‘AND

2 HEARING AIDS’’ after ‘‘ORTHOTICS’’; 

3 (ii) by inserting ‘‘, or of hearing aids 

4 described in paragraph (2)(D) of such sec5 tion,’’ after ‘‘2011,’’; and 

6 (iii) in clause (i), by inserting ‘‘or 

7 such hearing aids’’ after ‘‘such orthotics’’. 

8 (B) CONFORMING AMENDMENT.— 

9 (i) IN GENERAL.—Section 1847(a)(2) 

10 of the Social Security Act (42 U.S.C. 

11 1395w–3(a)(2)) is amended by adding at 

12 the end the following new subparagraph: 

13 ‘‘(D) HEARING AIDS.—Hearing aids de14 scribed in section 1861(s)(8) for which payment 

15 would otherwise be made under section 

16 1834(h).’’. 

17 (ii) EXEMPTION OF CERTAIN ITEMS

18 FROM COMPETITIVE ACQUISITION.—Sec19 tion 1847(a)(7) of the Social Security Act 

20 (42 U.S.C. 1395w–3(a)(7)) is amended by 

21 adding at the end the following new sub22 paragraph: 

23 ‘‘(C) CERTAIN HEARING AIDS.—Those 

24 items and services described in paragraph 

25 (2)(D) if furnished by a physician or other 


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1 practitioner (as defined by the Secretary) to the 

2 physician’s or practitioner’s own patients as 

3 part of the physician’s or practitioner’s profes4 sional service.’’. 

5 (4) INCLUSION OF QUALIFIED AUDIOLOGISTS

6 AND QUALIFIED HEARING AID PROFESSIONALS AS

7 CERTAIN PRACTITIONERS TO RECEIVE PAYMENT ON

8 AN ASSIGNMENT-RELATED BASIS.—Section 

9 1842(b)(18)(C) of the Social Security Act (42 

10 U.S.C. 1395u(b)(18)(C)), is amended by adding at 

11 the end the following new clauses: 

12 ‘‘(ix) Beginning on January 1, 2025, 

13 a qualified audiologist (as defined in sec14 tion 1861(ll)(4)(B)). 

15 ‘‘(x) A qualified hearing aid profes16 sional (as defined in section 

17 1861(ll)(4)(C)).’’. 

18 (c) EXCLUSION MODIFICATION.—Section 1862(a)(7) 

19 of the Social Security Act (42 U.S.C. 1395y(a)(7)) is 

20 amended by inserting ‘‘(except such hearing aids or exami21 nations therefor as described in and otherwise allowed 

22 under section 1861(s)(8))’’ after ‘‘hearing aids or exami23 nations therefor’’. 


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1 (d) INCLUSION AS EXCEPTED MEDICAL TREAT2 MENT.—Section 1821(b)(5)(A) of the Social Security Act 

3 (42 U.S.C. 1395i–5(b)(5)(A)) is amended— 

4 (1) in clause (i), by striking ‘‘or’’; 

5 (2) in clause (ii), by striking the period and in6 serting ‘‘, or’’; and 

7 (3) by adding at the end the following new 

8 clause: 

9 ‘‘(iii) consisting of audiology services 

10 described in subsection (ll)(3) of section 

11 1861, or hearing aids described in sub12 section (s)(8) of such section, that are pay13 able under part B as a result of the 

14 amendments made by the SALT Act.’’. 

15 (e) RURAL HEALTH CLINICS AND FEDERALLY

16 QUALIFIED HEALTH CENTERS.— 

17 (1) CLARIFYING COVERAGE OF AUDIOLOGY

18 SERVICES AS PHYSICIANS’ SERVICES.—Section 

19 1861(aa)(1)(A) of the Social Security Act (42 

20 U.S.C. 1395x(aa)(1)(A)) is amended by inserting 

21 ‘‘(including audiology services (as defined in sub22 section (ll)(3)))’’ after ‘‘physicians’ services’’. 

23 (2) INCLUSION OF QUALIFIED AUDIOLOGISTS

24 AND QUALIFIED HEARING AID PROFESSIONALS AS

25 RHC AND FQHC PRACTITIONERS.—Section 


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1 1861(aa)(1)(B) of the Social Security Act (42 

2 U.S.C. 1395x(aa)(1)(B)) is amended by inserting 

3 ‘‘or by a qualified audiologist or a qualified hearing 

4 aid professional (as such terms are defined in sub5 section (ll)),’’ after ‘‘(as defined in subsection 

6 (hh)(1)),’’. 

7 (3) TEMPORARY PAYMENT RATES FOR CERTAIN

8 SERVICES UNDER THE RHC AIR AND FQHC PPS.— 

9 (A) AIR.—Section 1833 of the Social Se10 curity Act (42 U.S.C. 1395l) is amended— 

11 (i) in subsection (a)(3)(A), by insert12 ing ‘‘(which shall, in the case of audiology 

13 services (as defined in section 1861(ll)(3)), 

14 in lieu of any limits on reasonable charges 

15 otherwise applicable, be based on the rates 

16 payable for such services under the pay17 ment basis determined under section 1848 

18 until such time as the Secretary deter19 mines sufficient data has been collected to 

20 otherwise apply such limits (or January 1, 

21 2031, if no such determination has been 

22 made as of such date))’’ after ‘‘may pre23 scribe in regulations’’; and 

24 (ii) by adding at the end the following 

25 new subsection: 


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1 ‘‘(ee) DISREGARD OF COSTS ATTRIBUTABLE TO CER2 TAIN SERVICES FROM CALCULATION OF RHC AIR.— 

3 Payments for rural health clinic services other than audi4 ology services (as defined in section 1861(ll)(3)) under the 

5 methodology for all-inclusive rates (established by the Sec6 retary) under subsection (a)(3) shall not take into account 

7 the costs of such services while rates for such services are 

8 based on rates payable for such services under the pay9 ment basis established under section 1848.’’. 

10 (B) PPS.—Section 1834(o) of the Social 

11 Security Act (42 U.S.C. 1395m(o)) is amended 

12 by adding at the end the following new para13 graph: 

14 ‘‘(5) TEMPORARY PAYMENT RATES BASED ON

15 PFS FOR CERTAIN SERVICES.—The Secretary shall, 

16 in establishing payment rates for audiology services 

17 (as defined in section 1861(ll)(3)) that are Federally 

18 qualified health center services under the prospective 

19 payment system established under this subsection, in 

20 lieu of the rates otherwise applicable under such sys21 tem, base such rates on rates payable for such serv22 ices under the payment basis established under sec23 tion 1848 until such time as the Secretary deter24 mines sufficient data has been collected to otherwise 

25 establish rates for such services under such system 


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1 (or January 1, 2031, if no such determination has 

2 been made as of such date). Payments for Federally 

3 qualified health center services other than such audi4 ology services under such system shall not take into 

5 account the costs of such services while rates for 

6 such services are based on rates payable for such 

7 services under the payment basis established under 

8 section 1848.’’. 

9 (f) IMPLEMENTATION.— 

10 (1) IN GENERAL.—In addition to amounts oth11 erwise available, the Secretary of Health and 

12 Human Services shall provide for the transfer from 

13 the Federal Supplementary Medical Insurance Trust 

14 Fund established under section 1841 of the Social 

15 Security Act (42 U.S.C. 1395t) to the Centers for 

16 Medicare & Medicaid Services Program Management 

17 Account of— 

18 (A) $20,000,000 for each of fiscal years 

19 2024 and 2025 for purposes of implementing 

20 the amendments made by this section; and 

21 (B) such sums as determined appropriate 

22 by the Secretary for each subsequent fiscal year 

23 for purposes of administering the provisions of 

24 such amendments. 


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1 (2) AVAILABILITY AND ADDITIONAL USE OF

2 FUNDS.—Funds transferred pursuant to paragraph 

3 (1) shall remain available until expended and may be 

4 used, in addition to the purposes specified in para5 graph (1), to implement the amendments made by 

6 section 4. 

7 (3) ADMINISTRATION.—The Secretary may im8 plement, by program instruction or otherwise, any of 

9 the provisions of, or amendments made by, this sec10 tion. 

11 SEC. 4. PROVIDING COVERAGE FOR VISION CARE UNDER 

12 THE MEDICARE PROGRAM. 

13 (a) COVERAGE.—Section 1861(s)(2) of the Social Se14 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 

15 (1) in subparagraph (II), by striking ‘‘and’’ 

16 after the semicolon at the end; 

17 (2) in subparagraph (JJ), by striking the pe18 riod at the end and adding ‘‘; and’’; and 

19 (3) by adding at the end the following new sub20 paragraph: 

21 ‘‘(KK) vision services (as defined in subsection 

22 (nnn));’’. 

23 (b) VISION SERVICES DEFINED.—Section 1861 of 

24 the Social Security Act (42 U.S.C. 1395x) is amended by 

25 adding at the end the following new subsection: 


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1 ‘‘(nnn) VISION SERVICES.—The term ‘vision services’ 

2 means— 

3 ‘‘(1) routine eye examinations to determine the 

4 refractive state of the eyes, including procedures per5 formed during the course of such examination; and 

6 ‘‘(2) contact lens fitting services, 

7 furnished on or after January 1, 2025, by or under the 

8 direct supervision of an ophthalmologist or optometrist 

9 who is legally authorized to furnish such examinations, 

10 procedures, or fitting services (as applicable) under State 

11 law (or the State regulatory mechanism provided by State 

12 law) of the State in which the examinations, procedures, 

13 or fitting services are furnished.’’. 

14 (c) PAYMENT LIMITATIONS.—Section 1834 of the 

15 Social Security Act (42 U.S.C. 1395m) is amended by 

16 adding at the end the following new subsection: 

17 ‘‘(aa) LIMITATION FOR VISION SERVICES.—With re18 spect to vision services (as defined in section 1861(nnn)) 

19 and an individual, payment may be made under this part 

20 for only 1 routine eye examination described in paragraph 

21 (1) of such section and 1 contact lens fitting service de22 scribed in paragraph (2) of such section during a 2-year 

23 period.’’. 

24 (d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 

25 Section 1848(j)(3) of the Social Security Act (42 U.S.C. 


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1 1395w–4(j)(3)) is amended by inserting ‘‘(2)(KK),’’ be2 fore ‘‘(3)’’. 

3 (e) COVERAGE OF CONVENTIONAL EYEGLASSES AND

4 CONTACT LENSES.— 

5 (1) IN GENERAL.—Section 1861(s)(8) of the 

6 Social Security Act (42 U.S.C. 1395x(s)(8)) is 

7 amended by striking ‘‘, and including one pair of 

8 conventional eyeglasses or contact lenses furnished 

9 subsequent to each cataract surgery with insertion 

10 of an intraocular lens’’ and inserting ‘‘, including 

11 one pair of conventional eyeglasses or contact lenses 

12 furnished subsequent to each cataract surgery with 

13 insertion of an intraocular lens, if furnished before 

14 January 1, 2025, and including conventional eye15 glasses or contact lenses (as described in section 

16 1834(h)(8)), whether or not furnished subsequent to 

17 such a surgery, if furnished on or after January 1, 

18 2025’’. 

19 (2) CONFORMING AMENDMENT.—Section 

20 1842(b)(11)(A) of the Social Security Act (42 

21 U.S.C. 1395u(b)(11)(A)) is amended by inserting 

22 ‘‘furnished prior to January 1, 2025,’’ after ‘‘relat23 ing to them,’’. 

24 (f) SPECIAL PAYMENT RULES FOR EYEGLASSES AND

25 CONTACT LENSES.— 


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1 (1) LIMITATIONS.—Section 1834(h) of the So2 cial Security Act (42 U.S.C. 1395m(h)), as amended 

3 by section 3, is further amended by adding at the 

4 end the following new paragraph: 

5 ‘‘(8) PAYMENT LIMITATIONS FOR EYEGLASSES

6 AND CONTACT LENSES.— 

7 ‘‘(A) IN GENERAL.—With respect to eye8 glasses and contact lenses furnished to an indi9 vidual on or after January 1, 2025, subject to 

10 subparagraph (B), payment may be made under 

11 this part only— 

12 ‘‘(i) during a 2-year period, for either 

13 1 pair of eyeglasses (including lenses and 

14 frames) or not more than a 2-year supply 

15 of contact lenses; 

16 ‘‘(ii) with respect to amounts attrib17 utable to the lenses and frames of such a 

18 pair of eyeglasses or amounts attributable 

19 to such a 2-year supply of contact lenses, 

20 in an amount not greater than— 

21 ‘‘(I) for a pair of eyeglasses fur22 nished in, or a 2-year supply of con23 tact lenses beginning in, 2025— 

24 ‘‘(aa) $85 for the lenses of 

25 such pair of eyeglasses and $85 


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1 for the frames of such pair of 

2 eyeglasses; or 

3 ‘‘(bb) $85 for such 2-year 

4 supply of contact lenses; and 

5 ‘‘(II) for the lenses and frames of 

6 a pair of eyeglasses furnished in, or a 

7 2-year supply of contact lenses begin8 ning in, a subsequent year, the dollar 

9 amounts specified under this subpara10 graph for the previous year, increased 

11 by the percentage change in the con12 sumer price index for all urban con13 sumers (United States city average) 

14 for the 12-month period ending with 

15 June of the previous year; 

16 ‘‘(iii) if furnished pursuant to a writ17 ten order of an ophthalmologist or optom18 etrist described in subsection (nnn); and 

19 ‘‘(iv) if during the 2-year period de20 scribed in clause (i), the individual did not 

21 already receive (as described in subpara22 graph (B)) one pair of conventional eye23 glasses or contact lenses subsequent to a 

24 cataract surgery with insertion of an intra25 ocular lens furnished during such period. 


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1 ‘‘(B) EXCEPTION.—With respect to a 2- 

2 year period described in subparagraph (A)(i), in 

3 the case of an individual who receives cataract 

4 surgery with insertion of an intraocular lens, 

5 notwithstanding subparagraph (A), payment 

6 may be made under this part for one pair of 

7 conventional eyeglasses or contact lenses fur8 nished subsequent to such cataract surgery dur9 ing such period. 

10 ‘‘(C) LIMITATION ON JUDICIAL REVIEW.— 

11 There shall be no administrative or judicial re12 view under section 1869 or otherwise of— 

13 ‘‘(i) the determination of the types of 

14 eyeglasses and contact lenses covered 

15 under this paragraph; or 

16 ‘‘(ii) the determination of fee schedule 

17 rates under this subsection for eyeglasses 

18 and contact lenses.’’. 

19 (2) APPLICATION OF COMPETITIVE ACQUISI20 TION.— 

21 (A) IN GENERAL.—Section 1834(h)(1)(H) 

22 of the Social Security Act (42 U.S.C. 

23 1395m(h)(1)(H)), as amended by section 3, is 

24 further amended— 


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1 (i) in the header, by striking ‘‘AND

2 HEARING AIDS’’ and inserting ‘‘HEARING

3 AIDS, EYEGLASSES, AND CONTACT

4 LENSES’’; 

5 (ii) by inserting ‘‘and of eyeglasses 

6 and contact lenses described in paragraph 

7 (2)(E) of such section,’’ after ‘‘paragraph 

8 (2)(D) of such section,’’; and 

9 (iii) in clause (i), by inserting ‘‘, or 

10 such eyeglasses and contact lenses’’ after 

11 ‘‘such hearing aids’’. 

12 (B) CONFORMING AMENDMENT.— 

13 (i) IN GENERAL.—Section 1847(a)(2) 

14 of the Social Security Act (42 U.S.C. 

15 1395w–3(a)(2)), as amended by section 3, 

16 is further amended by adding at the end 

17 the following new subparagraph: 

18 ‘‘(E) EYEGLASSES AND CONTACT

19 LENSES.—Eyeglasses and contact lenses de20 scribed in section 1861(s)(8) for which payment 

21 would otherwise be made under section 

22 1834(h).’’. 

23 (ii) EXEMPTION OF CERTAIN ITEMS

24 FROM COMPETITIVE ACQUISITION.—Sec25 tion 1847(a)(7) of the Social Security Act 


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1 (42 U.S.C. 1395w–3(a)(7)), as amended 

2 by section 3, is further amended by adding 

3 at the end the following new subparagraph: 

4 ‘‘(D) CERTAIN EYEGLASSES AND CONTACT

5 LENSES.—Those items and services described in 

6 paragraph (2)(E) if furnished by a physician or 

7 other practitioner (as defined by the Secretary) 

8 to the physician’s or practitioner’s own patients 

9 as part of the physician’s or practitioner’s pro10 fessional service.’’. 

11 (g) EXCLUSION MODIFICATIONS.—Section 1862(a) 

12 of the Social Security Act (42 U.S.C. 1395y(a)) is amend13 ed— 

14 (1) in paragraph (1)— 

15 (A) in subparagraph (O), by striking 

16 ‘‘and’’ at the end; 

17 (B) in subparagraph (P), by striking the 

18 semicolon at the end and inserting ‘‘, and’’; and 

19 (C) by adding at the end the following new 

20 subparagraph: 

21 ‘‘(Q) in the case of vision services (as defined 

22 in section 1861(nnn)) that are routine eye examina23 tions and contact lens fitting services (as described 

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1 tion), which are furnished more frequently than once 

2 during a 2-year period;’’; and 

3 (2) in paragraph (7)— 

4 (A) by inserting ‘‘(other than such an ex5 amination that is a vision service that is cov6 ered under section 1861(s)(2)(KK))’’ after ‘‘eye 

7 examinations’’; and 

8 (B) by inserting ‘‘(other than such a proce9 dure that is a vision service that is covered 

10 under section 1861(s)(2)(KK))’’ after ‘‘refrac11 tive state of the eyes’’. 

12 (h) IMPLEMENTATION.— 

13 (1) FUNDING.— 

14 (A) IN GENERAL.—In addition to amounts 

15 otherwise available, the Secretary of Health and 

16 Human Services (in this subsection referred to 

17 as the ‘‘Secretary’’) shall provide for the trans18 fer from the Federal Supplementary Medical 

19 Insurance Trust Fund under section 1841 of 

20 the Social Security Act (42 U.S.C. 1395t) to 

21 the Centers for Medicare & Medicaid Services 

22 Program Management Account of— 

23 (i) $20,000,000 for each of fiscal 

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1 plementing the amendments made by this 

2 section; and 

3 (ii) such sums as determined appro4 priate by the Secretary for each subse5 quent fiscal year for purposes of admin6 istering the provisions of such amend7 ments. 

8 (B) AVAILABILITY AND ADDITIONAL USE

9 OF FUNDS.—Funds transferred pursuant to 

10 subparagraph (A) shall remain available until 

11 expended and may be used, in addition to the 

12 purpose specified in subparagraph (A)(i), to im13 plement the amendments made by section 3. 

14 (2) ADMINISTRATION.—The Secretary may im15 plement, by program instruction or otherwise, any of 

16 the provisions of, or amendments made by, this sec17 tion. 

Æ 


kjohnson on DSK79L0C42PROD with BILLS