I 

110TH CONGRESS 

1ST SESSION H. R. 1845 

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 

MARCH 29, 2007 

Mr. TANNER (for himself, Mr. HOBSON, and Mr. ROSS) 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 2007’’. 

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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 OVERmstockstill on PROD1PC66 with BILLS

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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 all suppliers to continue to participate as 

21 suppliers at the selected award price so long as they 

22 submit bids at less than the fee schedule amount 

23 otherwise applicable to the items and they otherwise 

24 comply with applicable program requirements.’’. 

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1 (b) RESTORATION OF DUE PROCESS.—Section 

2 1847(b)(10) of such Act (42 U.S.C. 1395w–3(b)(10)) is 

3 amended— 

4 (1) by striking ‘‘NO ADMINISTRATIVE OR JUDI5 CIAL REVIEW’’ and inserting ‘‘RESTORATION OF AP6 PEAL RIGHTS’’; and 

7 (2) by striking ‘‘There shall be no administra8 tive or judicial review under section 1869, section 

9 1878, or otherwise of’’ and inserting ‘‘Administra10 tive and judicial review shall only be available under 

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

12 (c) APPLICATION OF REQUIREMENT FOR SIGNIFI13 CANT SAVINGS.—Section 1847(a) of such Act (42 U.S.C. 

14 1395w–3(a)) is amended— 

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

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

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

18 following new subparagraph: 

19 ‘‘(D) REQUIREMENT FOR SIGNIFICANT

20 SAVINGS.—The Secretary shall not implement a 

21 program under this section with respect to an 

22 item or service unless the Secretary dem23 onstrates a probability of achieving significant 

24 savings of at least 10 percent, compared to the 

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1 fee schedule in effect on January 1, 2007, by 

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

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

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

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

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

7 (2) by adding at the end the following new sub8 paragraphs: 

9 ‘‘(G) REQUIREMENT FOR COMPARABILITY

10 ANALYSIS BEFORE IMPLEMENTATION.—The 

11 Secretary may not implement subparagraph (F) 

12 with respect to the application of rates in an 

13 area that is not a competitive acquisition area 

14 under section 1847 unless the Secretary has 

15 completed and published in the Federal Reg16 ister a comparability analysis to ensure the ap17 plication is appropriate. The comparability 

18 analysis shall include at least an analysis of the 

19 relative costs of providing the particular items 

20 and services in the respective metropolitan sta21 tistical areas and an assessment of whether ap22 plication of the bid rate in an area that is not 

23 a competitive acquisition area would adversely 

24 impact beneficiary access to quality items and 

25 services. 

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1 ‘‘(H) APPLICATION OF COMPARABILITY

2 ANALYSIS REQUIREMENT TO CERTAIN OTHER

3 PART B ITEMS AND SERVICES.—Subparagraph 

4 (G) shall also apply to the implementation of 

5 section 1847(a) with respect to items described 

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

7 that are furnished on or after January 1, 

8 2009.’’. 

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

10 this section shall be effective as if included in the enact11 ment of the Medicare Prescription Drug, Improvement, 

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

13 SEC. 4. REPORT ON QUALITY AND ACCESS IMPACT OF IM14 PLEMENTATION AT 10 INITIAL COMPETITIVE 

15 ACQUISITION AREAS. 

16 (a) ANALYSIS AND REPORT.—After the Secretary of 

17 Health and Human Services has fully implemented the ini18 tial 10 competitive acquisition areas under section 1847 

19 of the Social Security Act, the Secretary shall conduct a 

20 complete analysis of the impact of competitive bidding in 

21 those areas, including its impact on beneficiary access to 

22 quality products and its impact on providers of items and 

23 services covered under competition and shall submit a re24 port to Congress on such analysis. 

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1 (b) MORATORIUM ON FURTHER IMPLEMENTATION

2 UNTIL CONGRESSIONAL ACTION.— 

3 (1) IN GENERAL.—Notwithstanding any other 

4 provision of law, the Secretary shall not expand the 

5 coverage of competitive acquisition programs under 

6 section 1847(a) of the Social Security Act (42 

7 U.S.C. 1395w–3(a)), or apply bid rates to non-bid 

8 areas under such section, beyond the 10 competitive 

9 acquisition areas identified under paragraph 

10 (1)(B)(i)(I) of such section as of the date of the en11 actment of this Act, unless specifically authorized by 

12 Congress after such date. 

13 (2) CONFORMING REFERENCE.—Section 

14 1847(a)(1)(B) of the Social Security Act (42 U.S.C. 

15 1395w–3(a)(1)(B)) is amended, in the matter before 

16 clause (i), by striking ‘‘The programs’’ and inserting 

17 ‘‘Subject to section 4(b)(1) of the Medicare Durable 

18 Medical Equipment Access Act of 2007, the pro19 grams’’. 

Æ 

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