I 
114TH CONGRESS 
2D SESSION 
H. R. 5210 
To improve access to durable medical equipment for Medicare beneficiaries 
under the Medicare program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 12, 2016 
Mr. TOM PRICE of Georgia (for himself, Mr. LOEBSACK, Mrs. MCMORRIS 
RODGERS, Mr. WELCH, Mr. COLLINS of New York, Mr. CRAMER, Mr. 
FLORES, Mr. HARPER, Mr. LUETKEMEYER, Mr. ROE of Tennessee, Mr. 
THOMPSON of Pennsylvania, Mr. TIPTON, Ms. DUCKWORTH, Mr. DUN-
CAN of Tennessee, Mr. JOYCE, Mr. ZINKE, Mr. KELLY of Pennsylvania, 
Mr. BLUM, Mrs. ELLMERS of North Carolina, Mr. GOHMERT, Mr. LONG, 
Mr. HARRIS, Mr. RENACCI, Mr. TIBERI, Mr. PETERSON, Mr. MURPHY 
of Pennsylvania, Mrs. NOEM, Mr. GIBBS, Mr. AUSTIN SCOTT of Georgia, 
Mr. GUTHRIE, Mr. DESJARLAIS, Ms. JENKINS of Kansas, Mr. DAVID 
SCOTT of Georgia, Mrs. BLACK, Mrs. BLACKBURN, Mr. SMITH of Mis-
souri, Mr. MULLIN, Mr. POMPEO, Mr. BYRNE, Mrs. WAGNER, and Mr. 
BOUSTANY) introduced the following bill; which was referred to the Com-
mittee 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 improve access to durable medical equipment for Medicare 
beneficiaries under the Medicare program, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Patient Access to Du-
rable Medical Equipment Act of 2016’’ or the ‘‘PADME 
Act’’. 
SEC. 2. EXTENSION OF THE TRANSITION TO NEW PAYMENT 
RATES FOR DURABLE MEDICAL EQUIPMENT 
UNDER THE MEDICARE PROGRAM. 
The Secretary of Health and Human Services shall 
extend the transition period described in clause (i) of sec-
tion 414.210(g)(9) of title 42, Code of Federal Regula-
tions, from June 30, 2016, to September 30, 2017 (with 
the full implementation described in clause (ii) of such sec-
tion applying to items and services furnished with dates 
of service on or after October 1, 2017). 
SEC. 3. BID CEILING FOR COMPETITIVE ACQUISITION FOR 
DURABLE MEDICAL EQUIPMENT UNDER THE 
MEDICARE PROGRAM. 
Section 1847(b)(5) of the Social Security Act (42 
U.S.C. 1395w–3(b)(5)) is amended— 
(1) in subparagraph (A)— 
(A) by inserting ‘‘, subject to subpara-
graph (E),’’ after ‘‘subsection (a)(2)’’; and 
(B) by inserting ‘‘, subject to subpara-
graph (E),’’ after ‘‘Based on such bids’’; and 
(2) by adding at the end the following new sub-
paragraph: 
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‘‘(E) BID CEILING FOR DURABLE MEDICAL 
EQUIPMENT.— 
‘‘(i) IN GENERAL.—The ceiling for a 
bid submitted for applicable covered items 
may not be less than the fee schedule 
amount that would otherwise be deter-
mined for such items under section 
1834(a), 
section 
1834(h), 
or 
section 
1842(s)(1) on January 1, 2015, updated 
by the covered item update for such items 
under 
section 
1834(a)(14)(L), 
section 
1834(h), or section 1842(s)(1), respec-
tively, as appropriate for the year with re-
spect to which the bid ceiling is established 
for such applicable covered item. 
‘‘(ii) APPLICATION TO NEW COVERED 
ITEMS.—The Secretary shall establish a 
process for purposes of applying clause (i) 
with respect to applicable covered items for 
which no fee schedule amount would other-
wise be paid under section 1834(a), section 
1834(h), or section 1842(s), as appro-
priate, on January 1, 2015. 
‘‘(iii) APPLICABLE
COVERED
ITEMS 
DEFINED.—For purposes of this subpara-
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graph, the term ‘applicable covered items’ 
means competitively priced items and serv-
ices described in subsection (a)(2) that are 
furnished with respect to rounds of com-
petition that begin on or after January 1, 
2017.’’. 
SEC. 4. REQUIREMENTS IN DETERMINING ADJUSTMENTS 
USING INFORMATION FROM COMPETITIVE 
BIDDING PROGRAMS. 
Section 1834(a)(1)(G) of the Social Security Act (42 
U.S.C. 1395m(a)(1)(G)) is amended by adding at the end 
the following new sentence: ‘‘In the case of items and serv-
ices furnished on or after January 1, 2019, in making any 
adjustments under clause (ii) or (iii) of subparagraph (F), 
the Secretary shall— 
‘‘(i) solicit and take into account 
stakeholder input; and 
‘‘(ii) take into account the highest 
amount bid by a winning supplier in a 
competitive acquisition area and a com-
parison of each of the following with re-
spect non-competitive acquisition areas and 
competitive acquisition areas: 
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‘‘(I) The average travel distance 
and cost associated with furnishing 
items and services in the area. 
‘‘(II) Any barriers to access for 
items and services in the area. 
‘‘(III) The average delivery time 
in furnishing items and services in the 
area. 
‘‘(IV) The average volume of 
items and services furnished by sup-
pliers in the area. 
‘‘(V) The number of suppliers in 
the area.’’. 
SEC. 5. MONTHLY REPORT ON THE RESULTS OF THE MONI-
TORING OF ACCESS OF MEDICARE BENE-
FICIARIES TO DURABLE MEDICAL EQUIP-
MENT AND OF HEALTH OUTCOMES. 
Not later than the first of each month (beginning 
with May 1, 2016, and ending with September 1, 2017), 
the Secretary of Health and Human Services shall publish 
on the Internet website of the Centers for Medicare & 
Medicaid Services the results of the monitoring of access 
of Medicare beneficiaries to durable medical equipment 
and of health outcomes, as described on page 66228 in 
the final rule published by the Center for Medicare & Med-
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