I

106TH CONGRESS

1ST SESSION H. R. 1938

To amend title XVIII of the Social Security Act to require appropriate

training and certification for suppliers of certain listed items of orthotics

or prosthetics.

IN THE HOUSE OF REPRESENTATIVES

MAY 25, 1999

Mr. WEXLER introduced the following bill; which was referred to the Committee on 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 require

appropriate training and certification for suppliers of

certain listed items of orthotics or prosthetics.

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 ‘‘William G. Barr Am5 putee Protection Act of 1999’’.
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1 SEC. 2. CERTIFICATION OF SUPPLIERS OF CERTAIN ITEMS

2 OF ORTHOTICS AND PROSTHETICS.

3 (a) IN GENERAL.—Section 1834(h)(1) of the Social

4 Security Act (42 U.S.C. 1395m(h)(1)) is amended by add5 ing at the end the following new subparagraph:

6 ‘‘(F) LIMITATION ON PAYMENT FOR LIST7 ED ITEMS.—

8 ‘‘(i) LIMITATION.—Except as provided

9 in clause (v), no payment may be made

10 under this subsection for an item of

11 orthotics and prosthetics that is specified

12 on a list established under clause (ii) un13 less the individual (as defined in clause

14 (vi)) furnishing such item has been cer15 tified under clause (iv).

16 ‘‘(ii) ESTABLISHMENT AND PUBLICA17 TION OF LIST.—The Secretary shall estab18 lish and publish a list of items of orthotics

19 and prosthetics that the Secretary (in con20 sultation with appropriate experts in the

21 field of orthotics and prosthetics) deter22 mines that because of the custom design,

23 fabrication, and fitting of such an item,

24 the individual furnishing such item must

25 meet minimum education requirements in

26 such design, fabrication, and fitting.
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1 ‘‘(iii) APPLICATION OF LIMITATION.—

2 The prohibition under clause (i) shall apply

3 to an item of orthotics and prosthetics fur4 nished on or after the date that is the first

5 day of the sixth month that begins after

6 the date on which the Secretary specifies

7 the item on the list under clause (ii).

8 ‘‘(iv) CERTIFICATION.—An individual

9 may be certified under this clause as fol10 lows:

11 ‘‘(I) IN GENERAL.—The Sec12 retary shall establish a process for the

13 certification of the individual by the

14 Secretary, by the State in which the

15 individual practices, or by a qualified

16 third party certifier (as determined by

17 the Secretary) as having met, with re18 spect to items specified on the list

19 under clause (ii), minimum education

20 requirements established by the Sec21 retary based on the criteria described

22 in subclause (II).

23 ‘‘(II) CRITERIA DESCRIBED.—

24 For purposes of subclause (I), the

25 regulations prescribed by the Sec-
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1 retary, in the case of such an indi2 vidual who is orthotist or prosthetist,

3 shall be based upon the essentials and

4 guidelines established by the Com5 mittee on Allied Health Education

6 and Accreditation of the American

7 Medical Association with respect to

8 education and training programs, in9 ternship or residency experience, and

10 continuing education requirements,

11 for the custom design, fabrication,

12 and fitting of such items. In the case

13 of such an individual who is a

14 pedorthist, such regulations shall be

15 based upon the essentials and guide16 lines established by the Committee for

17 Pedorthic Education Accreditation

18 with respect to education and training

19 programs, internship or residency ex20 perience, and continuing education re21 quirements, for the custom design,

22 fabrication, and fitting of such items.

23 In the case of an individual who is a

24 fitter of orthotics or prosthetics, such

25 regulations shall be based upon cri-
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1 teria established by the Secretary (in

2 conjunction with appropriate experts

3 in the field of orthotics) with respect

4 to education and training programs,

5 internship or residency experience,

6 and continuing education require7 ments, for the fitting of such items.

8 ‘‘(III) CERTIFICATION BY REA9 SON OF EXPERIENCE.—Notwith10 standing subclause (I), in the case of

11 a individual practicing in a State

12 which does not provide for such licen13 sure or certification, the individual

14 may be certified under this clause if

15 the individual has completed at least

16 five years practice in the field of

17 orthotics or prosthetics and meets

18 such other criteria as the Secretary

19 establishes.

20 ‘‘(v) RURAL SUPPLIERS EXCEPTED.—

21 The prohibition under clause (i) shall not

22 apply in the case of a supplier of an item

23 of orthotics and prosthetics that serves,

24 and is located in, an area outside a Metro-
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1 politan Statistical Area or a New England

2 County Metropolitan Area.

3 ‘‘(vi) INDIVIDUAL DEFINED.—For

4 purposes of this subparagraph, the term

5 ‘individual’ means a supplier of orthotics

6 and prosthetics who is a practitioner of

7 orthotics or prosthetics or, in the case of a

8 supplier who is not such a practitioner,

9 such a practitioner in the employ of the

10 supplier on a full- or part-time salary

11 basis.’’.

12 (b) DEADLINES.—

13 (1) LIST OF ITEMS.—Not later than six months

14 after the date of the enactment of this Act, the Sec15 retary of Health and Human Services shall publish

16 in the Federal Register the list of orthotic and pros17 thetic items described in clause (ii) of section

18 1834(h)(1)(F) of the Social Security Act (42 U.S.C.

19 1395m(h)(1)(F)), as added by subsection (a).

20 (2) REGULATIONS.—Not later than six months

21 after the date of the enactment of this Act, the Sec22 retary shall issue regulations to carry out the

23 amendment made by subsection (a). In order to

24 carry out this requirement in a timely manner, the

25 Secretary may promulgate regulations that take ef-
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1 fect on an interim basis, after notice and pending

2 opportunity for public comment.

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