I 

110TH CONGRESS 

1ST SESSION H. R. 2520 

To amend title XVIII of the Social Security Act to provide for coverage 

under the Medicare Program of certain medical mobility devices approved 

as class III medical devices. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 24, 2007 

Mr. LANGEVIN (for himself, Mr. RAMSTAD, Mr. FERGUSON, Mr. CAMP of 

Michigan, Mrs. BOYDA of Kansas, Ms. SHEA-PORTER, Mr. NUNES, Mr. 

ISSA, Mr. HINCHEY, Mr. JINDAL, Mr. COHEN, Mr. FARR, Mr. SARBANES, and Mr. ELLISON) 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 title XVIII of the Social Security Act to provide 

for coverage under the Medicare Program of certain medical mobility devices approved as class III medical devices. 

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


rwilkins on PROD1PC63 with BILLS
2 

•HR 2520 IH

1 SECTION 1. COVERAGE OF CLASS III MEDICAL MOBILITY 

2 DEVICES. 

3 (a) COVERED BENEFIT.—Section 1861(s)(2) of the 

4 Social Security Act (42 U.S.C. 1395x(s)(2)) is amended— 

5 (1) in subparagraph (Z), by striking ‘‘and’’ at 

6 the end; 

7 (2) in subparagraph (AA), by inserting ‘‘and’’ 

8 at the end; and 

9 (3) by adding at the end the following new sub10 paragraph: 

11 ‘‘(BB) class III medical mobility devices (as de12 fined in subsection (ccc)(1)) furnished to a class III 

13 medical mobility-device eligible individual (as defined 

14 in subsection (ccc)(2));’’. 

15 (b) DEFINITIONS.—Section 1861 of such Act (42 

16 U.S.C. 1395x) is amended by adding at the end the fol17 lowing new subsection: 

18 ‘‘Class III Medical Mobility Device; Class III Medical 

19 Mobility-Device Eligible Individual 

20 ‘‘(ccc)(1) The term ‘class III medical mobility device’ 

21 means a medical mobility device that has been approved 

22 as a class III medical device pursuant to a premarket ap23 proval application under the Federal Food, Drug, and 

24 Cosmetic Act and that— 

25 ‘‘(A) is able, among other functions— 


rwilkins on PROD1PC63 with BILLS
3 

•HR 2520 IH

1 ‘‘(i) to ascend and descend stairs using a 

2 climbing and descending function; 

3 ‘‘(ii) to traverse different terrain and var4 ious obstacles (including uneven terrain, curbs 

5 of 5 inches in height, grass, gravel, and other 

6 soft surfaces) using a 4-wheel drive function; 

7 and 

8 ‘‘(iii) to provide mobility in a seated posi9 tion at an elevated height using a balance func10 tion; 

11 ‘‘(B) has been prescribed for a class III medical 

12 mobility-device eligible individual (as defined in 

13 paragraph (2)) by the individual’s treating physician 

14 (as defined in subsection (r)(1)) for an approved in15 dication of the class III medical mobility device; and 

16 ‘‘(C) is only dispensed after an assessment of 

17 the class III medical mobility-device eligible indi18 vidual has been completed by a health care profes19 sional specified in paragraph (3) who has success20 fully completed training in making such assessments 

21 under standards specified by the Secretary in con22 sultation with representatives of appropriate indus23 try and medical organizations. 

24 ‘‘(2) The term ‘class III medical mobility-device eligi25 ble individual’ means, with respect to a class III medical 


rwilkins on PROD1PC63 with BILLS
4 

•HR 2520 IH

1 mobility device, an individual who, at the time the pre2 scription for the device is written, meets each of the fol3 lowing requirements: 

4 ‘‘(A) The individual has a functional limitation 

5 of mobility that hinders the individual’s ability to 

6 perform mobility-related activities of daily living. 

7 ‘‘(B) The use of the class III medical mobility 

8 device with respect to the individual is for uses of 

9 the device that have been approved by the Food and 

10 Drug Administration for the device. 

11 ‘‘(C) The individual demonstrates sufficient 

12 cognitive and physical ability for the proper and safe 

13 operation of the device (such as sufficient use of one 

14 upper extremity and the ability to dial a push button 

15 telephone or operate a hand operated joystick) under 

16 such medical standards as the Secretary may speci17 fy. 

18 ‘‘(D) The individual meets drivers licensing cri19 teria established in 1996 by the Epilepsy Founda20 tion of America. 

21 ‘‘(E) The individual is not a resident of an in22 stitution that meets the requirements of subsection 

23 (e)(1) or section 1819(a)(1). 

24 ‘‘(F) The individual has completed a com25 prehensive training program (that meets standards 


rwilkins on PROD1PC63 with BILLS
5 

•HR 2520 IH

1 developed by the Secretary in consultation with ap2 propriate industry representatives) on the safe oper3 ation of the class III medical mobility device and its 

4 functions. 

5 ‘‘(G) The individual was initially entitled to 

6 benefits under part A of this title by reason of sec7 tion 226(b). 

8 ‘‘(H) The residence of the individual— 

9 ‘‘(i) has stairs that meet the conditions of 

10 use of the class III medical mobility device for 

11 a stair as indicated in the labeling of the device; 

12 and 

13 ‘‘(ii) does not have a mechanical method to 

14 ascend or descend such a stair or stairs (such 

15 as an elevator or such other mechanical meth16 ods as the Secretary may specify). 

17 ‘‘(3) A health care professional specified in this para18 graph is any of the following: 

19 ‘‘(A) A physician (as defined in subsection 

20 (r)(1)). 

21 ‘‘(B) A physician assistant. 

22 ‘‘(C) A nurse practitioner. 

23 ‘‘(D) A qualified physical therapist. 

24 ‘‘(E) A qualified occupational therapist.’’. 

25 (c) CONFORMING AMENDMENTS.— 


rwilkins on PROD1PC63 with BILLS
6 

•HR 2520 IH

1 (1) PROVISION OF CLASS III MEDICAL MOBILITY

2 DEVICE ONLY TO CLASS III MEDICAL MOBILITY-DE3 VICE ELIGIBLE INDIVIDUAL; MEDICAL NECESSITY.— 

4 Section 1862 of such Act (42 U.S.C. 1395y) is 

5 amended— 

6 (A) in subsection (a)(1)— 

7 (i) in subparagraph (M), by striking 

8 ‘‘and’’ at the end; 

9 (ii) in subparagraph (N), by striking 

10 the semicolon at the end and inserting ‘‘, 

11 and’’; and 

12 (iii) by inserting after subparagraph 

13 (N) the following new subparagraph: 

14 ‘‘(O) in the case of a class III medical mo15 bility device (as defined in paragraph (1) of sec16 tion 1861(ccc)), which is furnished other than 

17 to a class III medical mobility-device eligible in18 dividual (as defined in paragraph (2) of such 

19 section);’’; and 

20 (B) by adding at the end the following new 

21 subsection: 

22 ‘‘(n) CLARIFICATION OF COVERAGE OF AND PAY23 MENT FOR ALL FUNCTIONS OF CLASS III MEDICAL MO24 BILITY DEVICES.—In the case of a class III medical mo25 bility device (as defined in section 1861(ccc)(1)) furnished 


rwilkins on PROD1PC63 with BILLS
7 

•HR 2520 IH

1 to a class III medical mobility-device eligible individual, 

2 each function of such device, including the functions de3 scribed in subparagraph (A) of such section, are deemed 

4 for purposes of subsection (a)(1), to be reasonable and 

5 necessary for the treatment of an illness or injury or to 

6 improve the functioning of a malformed body member.’’. 

7 (2) PAYMENT IN CONNECTION COVERED ITEMS; 

8 PURCHASE AGREEMENT OPTION; MAINTENANCE.— 

9 Section 1834(a) of such Act (42 U.S.C. 1395m(a)) 

10 is amended— 

11 (A) in paragraph (1)(B)(ii), by inserting 

12 ‘‘and (22)’’ after ‘‘(7)’’; 

13 (B) in paragraph (13), by inserting before 

14 the period at the end the following: ‘‘, and also 

15 includes a class III medical mobility device (as 

16 defined in section 1861(ccc)(1))’’; and 

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

18 paragraph: 

19 ‘‘(22) PAYMENT FOR CLASS III MEDICAL MOBIL20 ITY DEVICES.— 

21 ‘‘(A) IN GENERAL.—Subject to the sub22 paragraph (B), in the case of a class III med23 ical mobility device (as defined in section 

24 1861(ccc)(1)), the provisions of paragraph (7) 

25 (including the option for a purchase agreement 


rwilkins on PROD1PC63 with BILLS
8 

•HR 2520 IH

1 under subparagraph (A)(iii) of such paragraph) 

2 shall apply to such device under this paragraph 

3 in the same manner as those provisions apply 

4 to a covered item under paragraph (7). 

5 ‘‘(B) PAYMENT FOR ALL FUNCTIONS OF

6 CLASS III MEDICAL MOBILITY DEVICES.—In the 

7 case of a class III medical mobility device, pay8 ment under this paragraph for such device shall 

9 be made taking into account all functions of 

10 such device, consistent with section 1862(n).’’. 

11 (3) REQUIREMENT FOR FACE-TO-FACE EN12 COUNTER WITH A PHYSICIAN AND FOR WRITTEN

13 PRESCRIPTION.—Clause (iv) of section 

14 1834(a)(1)(E) of such Act (42 U.S.C. 

15 1395m(a)(1)(E)) is amended— 

16 (A) in the heading, by inserting ‘‘AND

17 CLASS III MEDICAL MOBILITY DEVICES’’ after 

18 ‘‘WHEELCHAIRS’’; and 

19 (B) by adding at the end the following: ‘‘In 

20 the case of a covered item consisting of a class 

21 III medical mobility device (as defined in para22 graph (1) of section 1861(ccc)) for a class III 

23 medical mobility-device eligible individual (as 

24 defined in paragraph (2) of such section), pay25 ment may not be made for such item under this 


rwilkins on PROD1PC63 with BILLS
9 

•HR 2520 IH

1 part unless a physician (as defined in section 

2 1861(r)) has conducted such examination and 

3 written such prescription for the item.’’. 

4 (d) EFFECTIVE DATE.—The amendments made by 

5 this section shall apply to devices furnished on or after 

6 the date of the enactment of this Act. 

Æ 


rwilkins on PROD1PC63 with BILLS