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[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4756 Introduced in House (IH)]

103d CONGRESS
  2d Session
                                H. R. 4756

    To amend title XVIII of the Social Security Act to require the 
Secretary of Health and Human Services to take into account the health 
   of a primary caregiver in determining whether an item of durable 
  medical equipment is considered medically necessary and appropriate 
                 under part B of the medicare program.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             July 14, 1994

  Mr. Brown of Ohio introduced the following bill; which was referred 
  jointly to the Committees on Ways and Means and Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
    To amend title XVIII of the Social Security Act to require the 
Secretary of Health and Human Services to take into account the health 
   of a primary caregiver in determining whether an item of durable 
  medical equipment is considered medically necessary and appropriate 
                 under part B of the medicare program.

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

SECTION 1. CONSIDERATION OF EFFECT OF DENIAL OF COVERAGE OF DURABLE 
              MEDICAL EQUIPMENT ON HEALTH OF PRIMARY CAREGIVER IN 
              MEDICAL NECESSITY DETERMINATIONS.

    (a) In General.--Section 1834(a)(1) of the Social Security Act (42 
U.S.C. 1395m(a)(1)) is amended by adding at the end the following new 
subparagraph:
                    ``(E) Consideration of needs of primary caregiver 
                in medical necessity determinations.--
                            ``(i) In general.--In determining whether 
                        payment may be made under this part for a 
                        covered item furnished to an individual living 
                        with a primary caregiver who assists the 
                        individual without monetary compensation in the 
                        performance of any of the activities of daily 
                        living described in clause (ii), the Secretary 
                        shall consider the effect of a denial of 
                        payment on the health of the primary caregiver 
                        in the determination of whether the item is 
                        reasonable and necessary for the diagnosis or 
                        treatment of illness or injury or to improve 
                        the functioning of a malformed body member with 
                        respect to the individual.
                            ``(ii) Activities of daily living 
                        described.--The `activities of daily living' 
                        referred to in clause (i) are as follows:
                                    ``(I) Eating.
                                    ``(II) Bathing.
                                    ``(III) Dressing.
                                    ``(IV) Toileting.
                                    ``(V) Transferring in and out of a 
                                bed or in and out of a chair.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to items furnished on or after January 1, 1995.
                                 <all>
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