‘‘(ii) routine exams, payment may be 
made under this part for only two such 
exams during a 12-month period. 
‘‘(B) SECRETARIAL AUTHORITY.— 
‘‘(i) AUTHORITY
TO
APPLY
ADDI-
TIONAL LIMITATIONS.—The Secretary may 
apply such other reasonable limitations on 
the extent to which dental and oral services 
are covered under this part, including 
through application of a prior authoriza-
tion requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of dental 
and oral health services to the extent that 
such modification is consistent with the 
recommendations of the United States Pre-
ventive Services Task Force.’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 
1395w–4(j)(3)) is amended by inserting ‘‘(2)(II),’’ before 
‘‘(3)’’. 
(e) DENTURES.— 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
(1) IN
GENERAL.—Section 1861(s)(8) of the 
Social Security Act (42 U.S.C. 1395x(s)(8)) is 
amended— 
(A) by striking ‘‘(other than dental)’’ and 
inserting ‘‘(including dentures)’’; and 
(B) by striking ‘‘internal body’’. 
(2) 
SPECIAL
PAYMENT
RULES.—Section 
1834(a) of the Social Security Act (42 U.S.C. 
1395m(a)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(23) PAYMENT AND LIMITS FOR DENTURES.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for dentures shall be, subject to 
subparagraph (C), the applicable percent (speci-
fied in subparagraph (B)) of the amount other-
wise payable for such dentures under this sec-
tion. 
‘‘(B) APPLICABLE
PERCENT.—For pur-
poses of subparagraph (A), the applicable per-
cent specified in this subparagraph is— 
‘‘(i) for the first year beginning at 
least 6 months after the date of the enact-
ment of this paragraph, 0 percent; 
‘‘(ii) for the year following the year 
specified in clause (i) and each subsequent 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
year through the seventh year following the 
year specified in clause (i), the applicable 
percent specified in this subparagraph for 
the previous year increased by 10 percent-
age points; and 
‘‘(iii) for the eighth year following the 
year specified in clause (i) and each subse-
quent year, 80 percent. 
‘‘(C) LIMITATIONS AND SECRETARIAL AU-
THORITY.— 
‘‘(i) IN GENERAL.—Payment may be 
made under this part for an individual 
for— 
‘‘(I) not more than one full upper 
and one full lower denture once every 
five years; and 
‘‘(II) not more than one partial 
upper denture and one partial lower 
denture once every five years. 
‘‘(ii) SECRETARIAL AUTHORITY.— 
‘‘(I) AUTHORITY TO APPLY ADDI-
TIONAL LIMITATIONS.—The Secretary 
may apply such other reasonable limi-
tations on the extent to which den-
tures are covered under this part, in-
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
cluding through application of a prior 
authorization requirement. 
‘‘(II) AUTHORITY
TO
MODIFY 
COVERAGE.—Notwithstanding 
any 
other provision of this title, if the Sec-
retary determines appropriate, the 
Secretary may modify the coverage 
under this part of dentures to the ex-
tent that such modification is con-
sistent with the recommendations of 
the United States Preventive Services 
Task Force.’’. 
(f) REPEAL OF GROUND FOR EXCLUSION.—Section 
1862(a) of the Social Security Act (42 U.S.C. 1395y) is 
amended by striking paragraph (12). 
(g) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1 of the first year beginning at least six months 
after the date of the enactment of this Act. 
SEC. 3. VISION CARE. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section 
2, is further amended— 
(1) in subparagraph (HH), by striking ‘‘and’’ 
after the semicolon at the end; 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
(2) in subparagraph (II), by adding ‘‘and’’ after 
the semicolon at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(JJ) vision services (as defined in subsection 
(lll));’’. 
(b) VISION SERVICES DEFINED.—Section 1861 of 
the Social Security Act (42 U.S.C. 1395x), as amended 
by section 2, is further amended by adding at the end the 
following new subsection: 
‘‘Vision Services 
‘‘(lll) The term ‘vision services’ means— 
‘‘(1) routine eye examinations and procedures 
performed (during the course of any eye examina-
tion) to determine the refractive state of the eyes; 
and 
‘‘(2) other necessary services related to eye and 
vision health (as defined by the Secretary).’’. 
(c) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by section 2, is further amended— 
(A) by striking ‘‘and’’ before ‘‘(DD)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (EE) with respect 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
to vision services (as defined in section 
1861(lll)), the amount paid shall be the pay-
ment amount specified under section 1834(y)’’. 
(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m), 
as amended by section 2, is further amended by add-
ing at the end the following new subsection: 
‘‘(y) PAYMENT AND LIMITS FOR VISION SERVICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for vision services (as defined in sec-
tion 1861(lll)) shall be, subject to paragraph (3), the 
applicable percent (specified in paragraph (2)) of the 
lesser of the actual charge for the services or the 
amount determined under the payment basis deter-
mined under section 1848. 
‘‘(2) APPLICABLE PERCENT.—For purposes of 
paragraph (1), the applicable percent specified in 
this paragraph is— 
‘‘(A) for the first year beginning at least 6 
months after the date of the enactment of this 
subsection, 0 percent; 
‘‘(B) for the year following the year speci-
fied in subparagraph (A) and each subsequent 
year through the seventh year following the 
year specified in subparagraph (A), the applica-
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
ble percent specified in this paragraph for the 
previous year increased by 10 percentage 
points; and 
‘‘(C) for the eighth year following the year 
specified in subparagraph (A) and each subse-
quent year, 80 percent. 
‘‘(3) LIMITATIONS AND SECRETARIAL AUTHOR-
ITY.— 
‘‘(A) FREQUENCY.—With respect to rou-
tine eye exams, payment may be made under 
this part for only one such exam during a 12- 
month period. 
‘‘(B) SECRETARIAL AUTHORITY.— 
‘‘(i) AUTHORITY
TO
APPLY
ADDI-
TIONAL LIMITATIONS.—The Secretary may 
apply other reasonable limitations on the 
extent to which vision services are covered 
under this part, including through applica-
tion of a prior authorization requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of vision 
services to the extent that such modifica-
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
tion is consistent with the recommenda-
tions of the United States Preventive Serv-
ices Task Force.’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 
1395w–4(j)(3)) is amended by inserting ‘‘(2)(JJ),’’ after 
‘‘(2)(II),’’ (as added by section 2). 
(e) SPECIAL PAYMENT RULES
FOR EYEGLASSES, 
CONTACT LENSES, AND LOW VISION DEVICES.—Section 
1834(a) of the Social Security Act (42 U.S.C. 1395m(a)), 
as amended by section 2, is further amended by adding 
at the end the following: 
‘‘(24) PAYMENT AND LIMITS FOR EYEGLASSES 
AND CONTACT LENSES.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for eyeglass lenses, eyeglass 
frames, and contact lenses shall be, subject to 
subparagraph (C), the applicable percent (speci-
fied in subparagraph (B)) of the amount other-
wise payable for such eyeglass lenses, eyeglass 
frames, and contact lenses, respectively, under 
this section. 
‘‘(B) APPLICABLE
PERCENT.—For pur-
poses of subparagraph (A), the applicable per-
cent specified in this subparagraph is— 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
‘‘(i) for the first year beginning at 
least 6 months after the date of the enact-
ment of this paragraph, 0 percent; 
‘‘(ii) for the year following the year 
specified in clause (i) and each subsequent 
year through the seventh year following the 
year specified in clause (i), the applicable 
percent specified in this subparagraph for 
the previous year increased by 10 percent-
age points; and 
‘‘(iii) for the eighth year following the 
year specified in clause (i) and each subse-
quent year, 80 percent. 
‘‘(C) LIMITATIONS AND SECRETARIAL AU-
THORITY.— 
‘‘(i) IN GENERAL.—Payment may be 
made under this part (other than for 
eyewear described in section 1861(s)(8)) 
for an individual for— 
‘‘(I) not more than one pair of 
eyeglass lenses during any 12-month 
period; 
‘‘(II) not more than one set of 
eyeglass frames during any 24-month 
period; and 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
‘‘(III) contact lenses, only to the 
extent that the sum of such payments 
for contact lenses does not exceed a 
limitation of $200 during any 24- 
month period beginning during the 
first year beginning at least six 
months after the date of the enact-
ment of this paragraph (or, beginning 
during a subsequent year, such limita-
tion for a 24-month period beginning 
in the previous year increase by an 
appropriate inflation adjustment spec-
ified by the Secretary). 
‘‘(ii) SECRETARIAL AUTHORITY.— 
‘‘(I) AUTHORITY TO APPLY ADDI-
TIONAL LIMITATIONS.—The Secretary 
may apply such other reasonable limi-
tations on the extent to which eye-
glass lenses, eyeglass frames, and con-
tact lenses are covered under this 
part, including through application of 
a prior authorization requirement. 
‘‘(II) AUTHORITY
TO
MODIFY 
COVERAGE.—Notwithstanding 
any 
other provision of this title, if the Sec-
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
retary determines appropriate, the 
Secretary may modify the coverage 
under this part of eyeglass lenses, eye-
glass frames, and contact lenses to 
the extent that such modification is 
consistent with the recommendations 
of the United States Preventive Serv-
ices Task Force. 
‘‘(25) PAYMENT AND LIMITS FOR LOW VISION 
DEVICES.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for low vision devices shall be, 
subject to subparagraph (C), the applicable per-
cent (specified in subparagraph (B)) of the 
amount otherwise payable for low vision devices 
under this section. 
‘‘(B) APPLICABLE
PERCENT.—For pur-
poses of subparagraph (A), the applicable per-
cent specified in this subparagraph is— 
‘‘(i) for the first year beginning at 
least 6 months after the date of the enact-
ment of this paragraph, 0 percent; 
‘‘(ii) for the year following the year 
specified in clause (i) and each subsequent 
year through the seventh year following the 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
year specified in clause (i), the applicable 
percent specified in this subparagraph for 
the previous year increased by 10 percent-
age points; and 
‘‘(iii) for the eighth year following the 
year specified in clause (i) and each subse-
quent year, 80 percent. 
‘‘(C) SECRETARIAL AUTHORITY.— 
‘‘(i) AUTHORITY
TO
APPLY
LIMITA-
TIONS.—The Secretary may apply reason-
able limitations on the extent to which low 
vision devices are covered under this part, 
including through application of a prior 
authorization requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of low vi-
sion devices to the extent that such modi-
fication is consistent with the recommenda-
tions of the United States Preventive Serv-
ices Task Force. 
‘‘(D) LOW VISION DEVICE DEFINED.—In 
this paragraph, the term ‘low vision device’ 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
means a device, prescribed by a physician, that 
magnifies, enhances, or otherwise augments or 
interprets visual images irrespective of the size, 
form, or technological features of such device 
and does not include ordinary eyeglasses or con-
tact lenses. In the previous sentence, the term 
‘ordinary eyeglasses or contact lenses’ means 
lenses that are intended to fully correct visual 
acuity or fully eliminate refractive error.’’. 
(f) DEFINITION OF DURABLE MEDICAL EQUIPMENT 
TO INCLUDE EYEGLASSES, CONTACT LENSES, AND LOW 
VISION DEVICES.—Section 1861(n) of the Social Security 
Act (42 U.S.C. 1395x(n)) is amended— 
(1) by striking ‘‘and’’ before ‘‘eye tracking’’ and 
inserting a comma; and 
(2) by inserting ‘‘, and eyeglass lenses, low vi-
sion devices (as defined in section 1834(a)(25)), eye-
glass frames, and contact lenses’’ before ‘‘; except’’. 
(g) REPEAL OF GROUND FOR EXCLUSION.—Section 
1862(a)(7) of the Social Security Act (42 U.S.C. 
1395y(a)(7)) is amended by striking ‘‘, eyeglasses (other 
than eyewear described in section 1861(s)(8)) or eye ex-
aminations for the purpose of prescribing, fitting, or 
changing eyeglasses, procedures performed (during the 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
course of any eye examination) to determine the refractive 
state of the eyes’’. 
(h) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1 of the first year beginning at least six months 
after the date of the enactment of this Act. 
SEC. 4. HEARING CARE. 
(a) COVERAGE.— 
(1) IN
GENERAL.—Section 1861(s)(2) of the 
Social Security Act (42 U.S.C. 1395x(s)(2)), as 
amended by sections 2 and 3, is further amended— 
(A) in subparagraph (II), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (JJ), by inserting 
‘‘and’’ at the end; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(KK) audiology services (as defined in sub-
section (ll)(3)) and hearing services (as defined in 
subsection (ll)(5));’’. 
(2) HEARING
SERVICES
DEFINED.—Section 
1861(ll) of the Social Security Act (42 U.S.C. 
1395x(ll)) is amended— 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
(A) in the subsection heading, by inserting 
‘‘; HEARING
SERVICES’’ after ‘‘AUDIOLOGY 
SERVICES’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(5) The term ‘hearing services’ means— 
‘‘(A) routine hearing exams and exams for 
hearing aids; and 
‘‘(B) other necessary services related to hearing 
health (as defined by the Secretary).’’. 
(b) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by sections 2 and 3, is further amended— 
(A) by striking ‘‘and’’ before ‘‘(EE)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (FF) with respect 
to audiology services (as defined in section 
1861(ll)(3)) and hearing services (as defined in 
section 1861(ll)(5)), the amount paid shall be 
the payment amount specified under section 
1834(z)’’. 
(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m), 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
as amended by sections 2 and 3, is further amended 
by adding at the end the following new subsection: 
‘‘(z) PAYMENT AND LIMITS FOR HEARING SERV-
ICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for audiology services (as defined in 
section 1861(ll)(3)) and hearing services (as defined 
in section 1861(ll)(5)), shall be, subject to para-
graph (3), the applicable percent (specified in para-
graph (2)) of the lesser of the actual charge for the 
services or the amount determined under the pay-
ment basis determined under section 1848. 
‘‘(2) APPLICABLE PERCENT.—For purposes of 
paragraph (1), the applicable percent specified in 
this paragraph is— 
‘‘(A) for the first year beginning at least 6 
months after the date of the enactment of this 
subsection, 0 percent; 
‘‘(B) for the year following the year speci-
fied in subparagraph (A) and each subsequent 
year through the seventh year following the 
year specified in subparagraph (A), the applica-
ble percent specified in this paragraph for the 
previous year increased by 10 percentage 
points; and 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
‘‘(C) for the eighth year following the year 
specified in subparagraph (A) and each subse-
quent year, 80 percent. 
‘‘(3) SECRETARIAL AUTHORITY.— 
‘‘(A) 
AUTHORITY
TO
APPLY
LIMITA-
TIONS.—The Secretary may apply reasonable 
limitations on the extent to which audiology 
services and hearing services are covered under 
this part, including through application of a 
prior authorization requirement. 
‘‘(B) AUTHORITY TO MODIFY COVERAGE.— 
Notwithstanding any other provision of this 
title, if the Secretary determines appropriate, 
the Secretary may modify the coverage under 
this part of audiology services and hearing serv-
ices to the extent that such modification is con-
sistent with the recommendations of the United 
States Preventive Services Task Force.’’. 
(c) PAYMENT UNDER THE PHYSICIAN FEE SCHED-
ULE.—Section 1848(j)(3) of the Social Security Act (42 
U.S.C. 1395w–4(j)(3)), as amended by section 2(d), is 
further amended by inserting ‘‘(2)(KK),’’ before ‘‘(3)’’. 
(d) HEARING AIDS.— 
(1) REPEAL
OF
GROUND
FOR
EXCLUSION.— 
Section 1862(a)(7) of the Social Security Act (42 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS
U.S.C. 1395y(a)(7)), as amended by section 3(g), is 
further amended by striking ‘‘, hearing aids or ex-
aminations therefor,’’. 
(2) DEFINITION OF DURABLE MEDICAL EQUIP-
MENT TO INCLUDE HEARING AIDS.—Section 1861(n) 
of the Social Security Act (42 U.S.C. 1395x(n)), as 
amended by section 3, is further amended by insert-
ing ‘‘hearing aids,’’ before ‘‘and eyeglass lenses’’. 
(3) SPECIAL
PAYMENT
RULES
FOR
HEARING 
AIDS.—Section 1834(a) of the Social Security Act 
(42 U.S.C. 1395m(a)), as amended by sections 2 
and 3, is further amended by adding at the end the 
following new paragraph: 
‘‘(26) PAYMENT
AND
LIMITS
FOR
HEARING 
AIDS.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for hearing aids shall be, sub-
ject to subparagraph (C), the applicable percent 
(specified in subparagraph (B)) of the amount 
otherwise payable for hearing aids under this 
section. 
‘‘(B) APPLICABLE
PERCENT.—For pur-
poses of subparagraph (A), the applicable per-
cent specified in this subparagraph is— 
VerDate Sep 11 2014 
00:31 Mar 08, 2019
Jkt 089200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H1393.IH
H1393
pamtmann on DSKBFK8HB2PROD with BILLS