II 

110TH CONGRESS 

1ST SESSION S. 1465 

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 SENATE OF THE UNITED STATES 

MAY 23, 2007 

Mr. CONRAD (for himself, Mr. ENZI, and Mr. REID) 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 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, 

3 SECTION 1. COVERAGE OF CLASS III MEDICAL MOBILITY 

4 DEVICES. 

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

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

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

8 the end; 

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

2 at the end; and 

3 (3) by adding at the end the following new sub4 paragraph: 

5 ‘‘(BB) class III medical mobility devices (as de6 fined in subsection (ccc)(1)) furnished to a class III 

7 medical mobility-device eligible individual (as defined 

8 in subsection (ccc)(2));’’. 

9 (b) DEFINITIONS.—Section 1861 of the Social Secu10 rity Act (42 U.S.C. 1395x) is amended by adding at the 

11 end the following new subsection: 

12 ‘‘Class III MEDICAL MOBILITY-DEVICE; CLASS III 

13 MEDICAL MOBILITY-DEVICE ELIGIBLE INDIVIDUAL

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

15 means a medical mobility device that has been approved 

16 as a class III medical device pursuant to a premarket ap17 proval application under the Federal Food, Drug, and 

18 Cosmetic Act and that— 

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

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

21 climbing and descending function; 

22 ‘‘(ii) to traverse different terrain and var23 ious obstacles (including uneven terrain, curbs 

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

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

2 and 

3 ‘‘(iii) to provide mobility in a seated posi4 tion at an elevated height using a balance func5 tion; 

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

7 mobility-device eligible individual (as defined in 

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

9 (as defined in subsection (r)(1)) for an approved in10 dication of the class III medical mobility device; and 

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

12 the class III medical mobility-device eligible indi13 vidual has been completed by a health care profes14 sional specified in paragraph (3) who has success15 fully completed training in making such assessments 

16 under standards specified by the Secretary in con17 sultation with representatives of appropriate indus18 try and medical organizations. 

19 ‘‘(2) The term ‘class III medical mobility-device eligi20 ble individual’ means, with respect to a class III medical 

21 mobility device, an individual who, at the time the pre22 scription for the device is written, meets each of the fol23 lowing requirements: 

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

2 of mobility that hinders the individual’s ability to 

3 perform mobility-related activities of daily living. 

4 ‘‘(B) The individual’s use of the class III med5 ical mobility device is for approved intended uses of 

6 the device. 

7 ‘‘(C) The individual demonstrates sufficient 

8 cognitive and physical ability for the proper and safe 

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

10 upper extremity and the ability to dial a push button 

11 telephone or operate a hand operated joystick) under 

12 such medical standards as the Secretary may speci13 fy. 

14 ‘‘(D) The individual meets drivers licensing cri15 teria established in 1996 by the Epilepsy Founda16 tion of America. 

17 ‘‘(E) The individual is not a resident of an in18 stitution that meets the requirements of subsection 

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

20 ‘‘(F) The individual has completed a com21 prehensive training program (that meets standards 

22 developed by the Secretary in consultation with ap23 propriate industry representatives) on the safe oper24 ation of the class III medical mobility device and its 

25 functions. 

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

2 benefits under this title solely by reason of section 

3 226(b). 

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

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

6 use of the class III medical mobility device for 

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

8 and 

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

10 ascend or descend such a stair or stairs (such 

11 as an elevator or such other mechanical meth12 ods as the Secretary may specify). 

13 ‘‘(3) A health care professional specified in this para14 graph is any of the following: 

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

16 (r)(1)). 

17 ‘‘(B) A physician assistant. 

18 ‘‘(C) A nurse practitioner. 

19 ‘‘(D) A qualified physical therapist. 

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

21 (c) CONFORMING AMENDMENTS.— 

22 (1) PROVISION OF CLASS III MEDICAL MOBILITY

23 DEVICE ONLY TO CLASS III MEDICAL MOBILITY-DE24 VICE ELIGIBLE INDIVIDUAL; MEDICAL NECESSITY.— 

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1 Section 1862 of the Social Security Act (42 U.S.C. 

2 1395y) is amended— 

3 (A) in subsection (a)(1)— 

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

5 ‘‘and’’ at the end; 

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

7 the semicolon at the end and inserting ‘‘, 

8 and’’; and 

9 (iii) by inserting after subparagraph 

10 (N) the following new subparagraph: 

11 ‘‘(O) in the case of a class III medical mo12 bility device (as defined in paragraph (1) of sec13 tion 1861(ccc)), which is furnished other than 

14 to a class III medical mobility-device eligible in15 dividual (as defined in paragraph (2) of such 

16 section);’’; and 

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

18 subsection: 

19 ‘‘(n) CLARIFICATION OF COVERAGE OF AND PAY20 MENT FOR ALL FUNCTIONS OF CLASS III MEDICAL MO21 BILITY DEVICES.—In the case of a class III medical mo22 bility device (as defined in section 1861(ccc)(1)) furnished 

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

24 each function of such device, including the functions de25 scribed in subparagraph (A) of such section, are deemed 

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

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

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

4 (2) PAYMENT IN CONNECTION WITH COVERED

5 ITEMS; PURCHASE AGREEMENT OPTION; MAINTE6 NANCE.—Section 1834(a) of the Social Security Act 

7 (42 U.S.C. 1395m(a)) is amended— 

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

9 ‘‘and paragraph (22), in the case of a class III 

10 medical mobility device,’’ after ‘‘(7)’’; 

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

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

13 includes a class III medical mobility device (as 

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

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

16 paragraph: 

17 ‘‘(22) PAYMENT FOR CLASS III MEDICAL MOBIL18 ITY DEVICES.— 

19 ‘‘(A) IN GENERAL.—Subject to the suc20 ceeding provisions of this paragraph, in the case 

21 of a class III medical mobility device (as de22 fined in section 1861(ccc)(1)), the provisions of 

23 paragraph (7) (including the option for a pur24 chase agreement under subparagraph (A)(iii) of 

25 such paragraph) shall apply to such device 

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1 under this paragraph in the same manner as 

2 those provisions apply to a covered item under 

3 paragraph (7). 

4 ‘‘(B) PAYMENT FOR ALL FUNCTIONS OF

5 CLASS III MEDICAL MOBILITY DEVICES.—In the 

6 case of a class III medical mobility device, pay7 ment under this paragraph for such device shall 

8 be made taking into account all functions of 

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

10 (3) REQUIREMENT FOR FACE-TO-FACE EN11 COUNTER WITH A PHYSICIAN AND FOR WRITTEN

12 PRESCRIPTION.—Clause (iv) of section 

13 1834(a)(1)(E) of the Social Security Act (42 U.S.C. 

14 1395m(a)(1)(E)) is amended— 

15 (A) by adding at the end the following: ‘‘In 

16 the case of a covered item consisting of a class 

17 III medical mobility device (as defined in para18 graph (1) of section 1861(ccc)) for a class III 

19 medical mobility-device eligible individual (as 

20 defined in paragraph (2) of such section), pay21 ment may not be made for such item unless a 

22 physician (as so defined) has conducted such 

23 examination and written such prescription for 

24 the item, and after an assessment of such indi25 vidual has been completed by a health care promstockstill on PROD1PC66 with BILLS

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1 fessional specified in paragraph (3) of such sec2 tion.’’; and 

3 (B) in the heading, by inserting ‘‘AND

4 CLASS III MEDICAL MOBILITY DEVICES’’ after 

5 ‘‘WHEELCHAIRS’’. 

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

7 this section shall apply to items and services furnished on 

8 or after the date of the enactment of this Act. 

Æ 

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