I

104TH CONGRESS

2D SESSION H. R. 3262

To amend title XVIII of the Social Security Act to expand coverage under

part B of the Medicare program of certain antibiotics which are

parenterally administered in a home setting, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

Ms. GREENE of Utah introduced the following bill; which was referred to the

Committee on 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 expand

coverage under part B of the Medicare program of certain antibiotics which are parenterally administered in

a home setting, and for other purposes.

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 ‘‘Common Sense Medi5 care Antibiotic Coverage Act of 1996’’.
2

•HR 3262 IH

1 SEC. 2. EXPANDED MEDICARE COVERAGE OF ANTIBIOTICS

2 ADMINISTERED PARENTERALLY IN HOME

3 SETTING.

4 (a) IN GENERAL.—Section 1861(n) of the Social Se5 curity Act (42 U.S.C. 1395x(n)) is amended—

6 (1) in the first sentence, by inserting ‘‘an anti7 biotic described in paragraph (2),’’ after ‘‘hospital

8 beds,’’;

9 (2) by striking ‘‘(n)’’ and inserting ‘‘(n)(1)’’;

10 and

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

12 paragraph:

13 ‘‘(2) An antibiotic described in this paragraph is any

14 of the following antibiotics which is administered

15 parenterally, using an access device that is inserted into

16 the body:

17 ‘‘(A) Vancomycin.

18 ‘‘(B) Cefazolin.

19 ‘‘(C) Ceftriaxone.

20 ‘‘(D) Ceftazidime.

21 ‘‘(E) Any other antibiotic which the Secretary

22 (in consultation with experts in the field of infec23 tious diseases) considers appropriate for purposes of

24 this subsection, taking into account medical neces25 sity and the extent to which coverage of the anti-
3

•HR 3262 IH

1 biotic under this subsection would result in savings

2 to the program under this title.’’.

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

4 subsection (a) shall apply to antibiotics furnished on or

5 after January 1, 1997.

6 SEC. 3. EFFECTS OF COVERAGE ON OVERALL EXPENDI7 TURES UNDER MEDICARE PROGRAM.

8 (a) REPORT ON ADJUSTMENTS TO PAYMENTS.—Not

9 later than April 1, 1997, the Secretary of Health and

10 Human Services shall make recommendations to Congress

11 concerning appropriate adjustments to the payment

12 amounts provided for items and services under title XVIII

13 of the Social Security Act to take into account the reduced

14 costs to individuals and entities providing such items and

15 services resulting from the coverage under part B of the

16 medicare program of certain antibiotics as items of dura17 ble medical equipment under section 1861(n) of the such

18 Act (as amended by section 2(a)).

19 (b) REQUIRING BUDGET-NEUTRALITY IN IMPLEMEN20 TATION OF COVERAGE.—The Secretary of Health and

21 Human Services shall adjust payment amounts provided

22 for items and services under title XVIII of the Social Se23 curity Act in such manner as the Secretary considers ap24 propriate to ensure that aggregate payments under such

25 title in any fiscal year are not greater or less than those
4

•HR 3262 IH

1 that would have been made in the year had section 2(a)

2 not been enacted into law.

3 SEC. 4. REPORT ON COVERAGE OF ADDITIONAL ANTI4 BIOTICS.

5 Not later than 1 year after the date of the enactment

6 of this Act, the Secretary of Health and Human Services

7 shall submit a report to Congress describing the additional

8 antibiotics to be treated as items of durable medical equip9 ment pursuant to section 1861(n)(2)(E) of the Social Se10 curity Act (as added by section 2(a)).

Æ