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Union Calendar No. 302 

116TH CONGRESS 

2D SESSION H. R. 4618 

[Report No. 116–326, Parts I and II] 

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

certain hearing items and services under part B of the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 8, 2019 

Mrs. MCBATH (for herself and Mrs. DINGELL) 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 

DECEMBER 6, 2019 

Reported from the Committee on Ways and Means with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

JANUARY 24, 2020 

Additional sponsors: Ms. CASTOR of Florida, Mr. CUELLAR, Ms. NORTON, Mr. 

HIGGINS of New York, and Mr. WELCH

JANUARY 24, 2020 

Reported from the Committee on Energy and Commerce, committed to the 

Committee of the Whole House on the State of the Union, and ordered 

to be printed 

[For text of introduced bill, see copy of bill as introduced on October 8, 2019] 


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•HR 4618 RH

A BILL 

To amend title XVIII of the Social Security Act to provide 

coverage for certain hearing items and services under 

part B of the Medicare program. 


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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 Hearing Act 

5 of 2019’’. 

6 SEC. 2. PROVIDING COVERAGE FOR HEARING CARE UNDER 

7 THE MEDICARE PROGRAM. 

8 (a) PROVISION OF AURAL REHABILITATION AND

9 TREATMENT SERVICES BY QUALIFIED AUDIOLOGISTS.— 

10 Section 1861(ll)(3) of the Social Security Act (42 U.S.C. 

11 1395x(ll)(3)) is amended by inserting ‘‘(and, beginning 

12 January 1, 2022, such aural rehabilitation and treatment 

13 services)’’ after ‘‘assessment services’’. 

14 (b) COVERAGE OF HEARING AIDS.— 

15 (1) INCLUSION OF HEARING AIDS AS PROS16 THETIC DEVICES.—Section 1861(s)(8) of the Social 

17 Security Act (42 U.S.C. 1395x(s)(8)) is amended by 

18 inserting ‘‘, and including hearing aids furnished on 

19 or after January 1, 2022, to individuals diagnosed 

20 with profound or severe hearing loss’’ before the semi21 colon at the end. 

22 (2) PAYMENT LIMITATIONS FOR HEARING

23 AIDS.—Section 1834(h) of the Social Security Act (42 

24 U.S.C. 1395m(h)) is amended by adding at the end 

25 the following new paragraph: 


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1 ‘‘(6) LIMITATIONS FOR HEARING AIDS.—Pay2 ment may be made under this part with respect to an 

3 individual, with respect to hearing aids furnished on 

4 or after January 1, 2022— 

5 ‘‘(A) not more than once during any 5-year 

6 period; 

7 ‘‘(B) only for types of such hearing aids 

8 that are not over-the-counter hearing aids (as de9 fined in section 520(q)(1) of the Federal Food, 

10 Drug, and Cosmetic Act) and that are deter11 mined appropriate by the Secretary; and 

12 ‘‘(C) only if furnished pursuant to a writ13 ten order of a physician or qualified audiologist 

14 (as defined in section 1861(ll)(4)(B)).’’. 

15 (3) APPLICATION OF COMPETITIVE ACQUISI16 TION.— 

17 (A) IN GENERAL.—Section 1834(h)(1)(H) of 

18 the Social Security Act (42 U.S.C. 

19 1395m(h)(1)(H)) is amended— 

20 (i) in the header, by inserting ‘‘AND

21 HEARING AIDS’’ before the semicolon; 

22 (ii) by inserting ‘‘and of hearing aids 

23 described in paragraph (2)(D) of such sec24 tion,’’ after ‘‘2009,’’; and 


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1 (iii) in clause (i), by inserting ‘‘or 

2 such hearing aids’’ after ‘‘such orthotics’’. 

3 (B) CONFORMING AMENDMENT.— 

4 (i) IN GENERAL.—Section 1847(a)(2) 

5 of the Social Security Act (42 U.S.C. 

6 1395w–3(a)(2)) is amended by adding at 

7 the end the following new subparagraph: 

8 ‘‘(D) HEARING AIDS.—Hearing aids for 

9 which payment would otherwise be made under 

10 section 1834(h).’’. 

11 (ii) EXEMPTION OF CERTAIN ITEMS

12 FROM COMPETITIVE ACQUISITION.—Section 

13 1847(a)(7) of the Social Security Act (42 

14 U.S.C. 1395w–3(a)(7)) is amended by add15 ing at the end the following new subpara16 graph: 

17 ‘‘(C) CERTAIN HEARING AIDS.—Those items 

18 and services described in paragraph (2)(D) if 

19 furnished by a physician or other practitioner 

20 (as defined by the Secretary) to the physician’s 

21 or practitioner’s own patients as part of the phy22 sician’s or practitioner’s professional service.’’. 

23 (4) INCLUSION OF AUDIOLOGISTS AS CERTAIN

24 PRACTITIONERS TO RECEIVE PAYMENT ON AN ASSIGN25 MENT-RELATED BASIS.—Section 1842(b)(18)(C) of the 


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1 Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is 

2 amended by adding at the end the following new 

3 clause: 

4 ‘‘(vii) With respect to 2022 and each 

5 subsequent year, a qualified audiologist (as 

6 defined in section 1861(ll)(4)(B)).’’. 

7 (c) EXCLUSION MODIFICATION.—Section 1862(a)(7) of 

8 the Social Security Act (42 U.S.C. 1395y(a)(7)) is amended 

9 by inserting ‘‘(except such hearing aids or examinations as 

10 described in and otherwise allowed under section 

11 1861(s)(8))’’ after ‘‘hearing aids or examinations therefor’’. 

12 SEC. 3. IMPLEMENTATION FUNDING. 

13 The Secretary of Health and Human Services shall 

14 provide for the transfer from the Federal Supplementary 

15 Medical Insurance Trust Fund under section 1841 of the 

16 Social Security Act (42 U.S.C. 1395t) to the Centers for 

17 Medicare & Medicaid Services Program Management Ac18 count for the period of 2020 through 2024 of such sums as 

19 may be necessary for purposes of implementing the amend20 ments made by section 2. 

21 SEC. 4. REPORT. 

22 (a) REPORT.—Not later than the date that is 2 years 

23 after the date of the enactment of the Medicare Hearing Act 

24 of 2019, the Inspector General of the Department of Health 

25 and Human Services shall— 


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1 (1) determine the feasibility of qualified audiol2 ogists (as defined in paragraph (4)(B) of 1861(ll) of 

3 the Social Security Act (42 U.S.C. 1395x(ll))) fur4 nishing audiology services (as defined in paragraph 

5 (3) of such section) to individuals entitled to benefits 

6 under part A of title XVIII of such Act (42 U.S.C. 

7 1395c et seq.) and enrolled for benefits under part B 

8 of such title (42 U.S.C.1395j et seq.) without such in9 dividuals being referred by a physician (as defined in 

10 section 1861(r) of such Act (42 U.S.C. 1395x(r))) or 

11 practitioner (as described in section 1842(b)(18)(C) of 

12 such Act (42 U.S.C. 1395u(b)(18)(C))) to qualified 

13 audiologists; and 

14 (2) submit to the Secretary of Health and 

15 Human Services a report on the feasibility of the re16 ferral described in paragraph (1) and any program 

17 integrity or overutilization concerns with respect to 

18 such referral. 

19 (b) REGULATIONS.—The Secretary of Health and 

20 Human Services may promulgate regulations to allow 

21 qualified audiologists to furnish audiology services without 

22 a referral from a physician or practitioner, consistent with 

23 the findings submitted to the Secretary pursuant to sub24 section (a)(2). 


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Union Calendar No. 302 

116TH CONGRESS 

2D SESSION H. R. 4618 

[Report No. 116–326, Parts I and II] 

A BILL 

To amend title XVIII of the Social Security Act to 

services under part B of the Medicare program. provide coverage for certain hearing items and 

JANUARY 24, 2020 

Reported from the Committee on Energy and Commerce, 

the State of the Union, and ordered to be printed committed to the Committee of the Whole House on 


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