Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2023

Subjects: Health


<html><body><pre>[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2639 Introduced in House (IH)]

&lt;DOC&gt;






118th CONGRESS
  1st Session
                                H. R. 2639

    To amend title XVIII of the Social Security Act to provide for 
  additional requirements with respect to electrodiagnostic services 
                      under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 17, 2023

 Mr. Sessions 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

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to provide for 
  additional requirements with respect to electrodiagnostic services 
                      under the Medicare program.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Electrodiagnostic Medicine Patient 
Protection and Fraud Elimination Act of 2023''.

SEC. 2. ADDITIONAL REQUIREMENTS FOR ELECTRODIAGNOSTIC SERVICES.

    Section 1834 of the Social Security Act (42 U.S.C. 1395m) is 
amended by adding at the end the following new subsection:
    ``(z) Payment for Electrodiagnostic Services.--
            ``(1) In general.--No payment may be made under this part 
        for electrodiagnostic services described in paragraph (2) 
        furnished on or after a date determined appropriate by the 
        Secretary that is not earlier than 3 years after the date of 
        the enactment of this subsection and not later than 4 years 
        after such date of enactment that are not furnished at a 
        qualified facility.
            ``(2) Electrodiagnostic services.--The services described 
        in this paragraph are the following:
                    ``(A) Nerve conduction studies.
                    ``(B) Needle electromyography tests.
            ``(3) Qualified facility.--In this subsection, the term 
        `qualified facility' means a facility accredited by an 
        organization specified by the Secretary pursuant to paragraph 
        (4).
            ``(4) Accreditation organizations.--
                    ``(A) In general.--Not later than 2 years after the 
                date of the enactment of this subsection, the Secretary 
                shall specify accrediting organizations, in 
                consultation with the advisory committee described in 
                paragraph (5), for purposes determining whether a 
                facility is a qualified facility. The Secretary may 
                specify an organization pursuant to the preceding 
                sentence only if such organization requires, as a 
                condition of accreditation of a facility by such 
                organization, that such facility meet the requirements 
                described in subparagraph (B). In making such 
                specification, the Secretary shall--
                            ``(i) ensure that the number of accrediting 
                        organizations so specified is adequate to 
                        facilitate the accreditation of facilities; and
                            ``(ii) prioritize such specification of 
                        accrediting organizations that are widely 
                        recognized by both public and private entities 
                        as having experience in the accreditation of 
                        such facilities.
                    ``(B) Facility requirements.--The requirements 
                described in this subparagraph are, with respect to a 
                facility and electrodiagnostic services furnished at 
                such facility, the following:
                            ``(i) The facility establishes and 
                        maintains a quality assurance and control 
                        program to ensure the reliability, safety, and 
                        accuracy of such service.
                            ``(ii) The facility ensures that such 
                        service is conducted using a device capable of 
                        performing both nerve conduction studies that 
                        record amplitude and latency and needle 
                        electromyography tests capable of real-time 
                        waveform display and analysis.
                            ``(iii) In the case that such service is a 
                        needle electromyography test, the facility 
                        ensures that the individual furnishing such 
                        test has completed not less than 3 months of 
                        training in performing and interpreting 
                        electrodiagnostic studies during a residency or 
                        fellowship program accredited by the 
                        Accreditation Council for Graduate Medical 
                        Education or the Royal College of Physicians 
                        and Surgeons of Canada, or by an individual 
                        described in section 410.32(b)(2)(iv) of title 
                        42, Code of Federal Regulations (or a successor 
                        regulation).
                            ``(iv) The facility ensures that the 
                        results are interpreted on-site and at the time 
                        of the procedure--
                                    ``(I) in the case of a needle 
                                electromyography test, by the 
                                individual who performed such test; and
                                    ``(II) in the case of a nerve 
                                conduction study, by the individual who 
                                performed or supervised such study.
                            ``(v) Any other requirement determined 
                        appropriate by the Secretary.
                    ``(C) Regulations.--Not later than 1 year after the 
                date of the enactment of this subsection, the Secretary 
                shall finalize regulations that outline--
                            ``(i) the process by which an accrediting 
                        organization may be specified under 
                        subparagraph (A);
                            ``(ii) the duration and the minimum time 
                        period between reviews for reaccreditation an 
                        organization so specified must provide for with 
                        respect to an accreditation of a facility made 
                        by such organization;
                            ``(iii) the process by which the Secretary 
                        may withdraw approval of an accrediting 
                        organization so specified if the Secretary 
                        determines that such organization no longer 
                        requires, as a condition of accreditation of a 
                        facility by such organization, that such 
                        facility meet the requirements described in 
                        subparagraph (B); and
                            ``(iv) the effect such a withdrawal will 
                        have on facilities accredited by such 
                        organization as of the date of such withdrawal.
            ``(5) Advisory committee.--
                    ``(A) In general.--Not later than 2 years after the 
                date of the enactment of this subsection, the Secretary 
                shall establish an advisory committee to be known as 
                the `National Electrodiagnostic Services Advisory 
                Committee' (in this subsection referred to as the 
                `committee') for purposes of carrying out the duties 
                specified in subparagraph (B).
                    ``(B) Duties.--The duties of the committee are the 
                following:
                            ``(i) To provide to the Secretary 
                        recommendations with respect to requirements 
                        that may be determined appropriate by the 
                        Secretary pursuant to paragraph (4)(B)(v), 
                        including any proposed additions to such 
                        requirements or modifications of such 
                        requirements. In developing such 
                        recommendations, the committee shall 
                        prioritize--
                                    ``(I) reducing unnecessary 
                                treatments and surgeries;
                                    ``(II) decreasing the need for 
                                retesting of individuals;
                                    ``(III) enhancing the reliability 
                                of diagnoses and promoting positive 
                                health outcomes for individuals;
                                    ``(IV) addressing emerging waste, 
                                fraud, and abuse schemes; and
                                    ``(V) otherwise improving the 
                                quality of care for individuals.
                            ``(ii) To provide to the Secretary 
                        recommendations regarding the regulations 
                        described in paragraph (4)(C).
                            ``(iii) To provide to the Secretary 
                        recommendations with respect to whether 
                        accrediting organizations seeking to be 
                        specified pursuant to paragraph (4)(A) should 
                        be so specified.
                    ``(C) Composition.--The committee shall be composed 
                of not fewer than 9 and not more than 11 individuals 
                selected by the Secretary. Such individuals shall not 
                be officers or employees of the Federal Government and 
                shall include--
                            ``(i) at least one physician with 
                        experience in furnishing electrodiagnostic 
                        services described in paragraph (2) in a lab 
                        accredited by an organization determined 
                        appropriate by the Secretary;
                            ``(ii) at least one physical therapist that 
                        is certified in clinical electrophysiology by 
                        an organization determined appropriate by the 
                        Secretary;
                            ``(iii) other health care practitioners;
                            ``(iv) at least one patient representing an 
                        affected community; and
                            ``(v) other individuals determined 
                        appropriate by the Secretary.
                    ``(D) Meetings.--The committee shall convene not 
                less than twice each year.''.
                                 &lt;all&gt;
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