II 

118TH CONGRESS 

2D SESSION S. 3977 

To amend title XVIII of the Social Security Act to protect beneficiaries 

with limb loss and other orthopedic conditions by providing access to 

appropriate, safe, effective, patient-centered orthotic and prosthetic care; 

to reduce fraud, waste, and abuse with respect to orthotics and prosthetics, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 19, 2024 

Mr. WARNER (for himself, Mr. DAINES, Ms. KLOBUCHAR, and Mr. CORNYN) 

introduced the following bill; which was read twice and referred to the 

Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to protect 

beneficiaries with limb loss and other orthopedic conditions by providing access to appropriate, safe, effective, 

patient-centered orthotic and prosthetic care; to reduce 

fraud, waste, and abuse with respect to orthotics and 

prosthetics, 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 ‘‘Medicare Orthotics and 

5 Prosthetics Patient-Centered Care Act’’. 


lotter on DSK11XQN23PROD with BILLS
2 

•S 3977 IS

1 SEC. 2. INCREASING PROTECTIONS FOR MEDICARE BENE2 FICIARIES RECEIVING ORTHOTIC AND PROS3 THETIC CARE. 

4 (a) PROHIBITION ON PAYMENT FOR ITEMS DELIV5 ERED BY DROP SHIPMENT.— 

6 (1) IN GENERAL.—Section 1834(h)(1) of the 

7 Social Security Act (42 U.S.C. 1395m(h)(1)) is 

8 amended by adding at the end the following new 

9 subparagraph: 

10 ‘‘(I) PROHIBITION ON PAYMENT FOR CER11 TAIN ITEMS FURNISHED USING A DROP SHIP12 MENT.— 

13 ‘‘(i) IN GENERAL.—No payment shall 

14 be made under this subsection for an item 

15 described in clause (ii) furnished to an in16 dividual via a drop shipment. 

17 ‘‘(ii) ITEMS DESCRIBED.—This items 

18 described in this clause are the following: 

19 ‘‘(I) A prosthesis (as defined in 

20 paragraph (4)(C)), except that such 

21 term does not include supplies for 

22 such prosthesis. 

23 ‘‘(II) A custom-fabricated ortho24 sis (as described in subparagraph 

25 (F)(ii)), or a custom-fitted orthosis, 


lotter on DSK11XQN23PROD with BILLS
3 

•S 3977 IS

1 except that such term does not in2 clude supplies for such orthosis. 

3 ‘‘(III) Off-the-shelf orthotics (as 

4 defined in section 1847(a)(2)(C)) that 

5 are not otherwise subject to competi6 tive bidding and are delivered by drop 

7 shipment. 

8 ‘‘(iii) DROP SHIPMENT DEFINED.—In 

9 this subparagraph, the term ‘drop ship10 ment’ means the direct shipment of a pros11 thesis or an orthosis to an individual that 

12 has not received training or education with 

13 respect to fitting and adjustment or train14 ing in the care and use of such prosthesis 

15 or orthosis from a qualified practitioner 

16 (as described in subparagraph (F)(iii)).’’. 

17 (2) EFFECTIVE DATE.—The amendment made 

18 by paragraph (1) shall apply to items furnished on 

19 or after the first day of the first full calendar year 

20 following the date of enactment of this Act. 

21 (b) ADDITIONAL PRACTITIONERS EXEMPT FROM

22 COMPETITIVE ACQUISITION.—Section 1847(a)(7)(A)(i) of 

23 the Social Security Act (42 U.S.C. 1395w–3(a)(7)(A)(i)) 

24 is amended— 


lotter on DSK11XQN23PROD with BILLS
4 

•S 3977 IS

1 (1) by inserting ‘‘, physical therapist, occupa2 tional therapist, orthotist, prosthetist’’ after ‘‘by a 

3 physician’’; and 

4 (2) by inserting ‘‘, physical therapist, occupa5 tional therapist, orthotist, prosthetist’’ after ‘‘the 

6 physician’s’’ in each place such term occurs. 

7 (c) ENSURING BENEFICIARY ACCESS TO REPLACE8 MENT CUSTOM-FITTED ORTHOTIC DEVICES AND CUS9 TOM-FABRICATED ORTHOTIC DEVICES.—Section 

10 1834(h)(1)(G) of the Social Security Act (42 U.S.C. 

11 1395m(h)(1)(G)) is amended— 

12 (1) in the heading, by inserting ‘‘, CUSTOM13 FITTED ORTHOTIC DEVICES, CUSTOM-FABRICATED

14 ORTHOTIC DEVICES,’’ after ‘‘REPLACEMENT OF

15 PROSTHETIC DEVICES’’; and 

16 (2) in clause (i), by inserting ‘‘, replacement of 

17 custom-fitted orthotic devices, replacement of cus18 tom-fabricated orthotic devices,’’ after ‘‘which are 

19 artificial limbs,’’. 

20 (d) UPDATING DEFINITIONS OF ORTHOTICS AND

21 PROSTHETICS.—Section 1834(h)(4)(C) of the Social Se22 curity Act (42 U.S.C. 1395m(h)(4)(C)) is amended by 

23 striking ‘‘the term ‘orthotics and prosthetics’ has the 

24 meaning given such term’’, and inserting ‘‘the terms 


lotter on DSK11XQN23PROD with BILLS
5 

•S 3977 IS

1 ‘orthotics and prosthetics’ and ‘orthoses and prostheses’ 

2 have the meaning given such terms’’. 

3 (e) REGULATIONS.—Not later than 1 year after the 

4 date of the enactment of this Act, the Secretary of Health 

5 and Human Services shall promulgate final regulations to 

6 implement the amendments made by this Act. 

Æ 


lotter on DSK11XQN23PROD with BILLS