SEPTEMBER 19, 2024 
Reported from the Committee on Energy and Commerce with amendments 
[Strike out all after the enacting clause and insert the part printed in italic] 
SEPTEMBER 19, 2024 
Committee on Ways and Means discharged; committed to the Committee of 
the Whole House on the State of the Union and ordered to be printed 
[For text of introduced bill, see copy of bill as introduced on September 18, 2023] 
A BILL 
To amend title XVIII of the Social Security Act to clarify 
the application of the in-office ancillary services exception 
to the physician self-referral prohibition for drugs fur-
nished under the Medicare program. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Seniors’ Access to Crit-
ical Medications Act of 2024’’. 
SEC. 2. CLARIFYING THE APPLICATION OF THE IN-OFFICE 
ANCILLARY SERVICES EXCEPTION TO THE 
PHYSICIAN 
SELF-REFERRAL 
PROHIBITION 
FOR COVERED OUTPATIENT DRUGS FUR-
NISHED UNDER THE MEDICARE PROGRAM. 
(a) IN GENERAL.—Section 1877(b)(2) of the Social Se-
curity Act (42 U.S.C. 1395nn(b)(2)) is amended by adding 
at the end the following new sentence: ‘‘With respect to serv-
ices described in subsection (h)(6)(J) consisting of covered 
part D drugs (as defined in section 1860D–2(e)) furnished 
to an individual during the period beginning on January 
1, 2025, and ending on December 31, 2029, such drugs shall 
be treated as having been furnished in accordance with sub-
paragraph (A)(ii) if such drugs are picked up in a building 
described in subclause (I) or (II) of such subparagraph by 
such individual, or a family member or caregiver on behalf 
of such individual, or delivered to such individual by a 
mail, delivery, or courier service, but only if, during the 
1-year period ending on the date such drugs were so fur-
nished, such individual had a face-to-face encounter with 
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the prescriber of such drugs (not including any such en-
counter conducted via telehealth), and only if such indi-
vidual has an ongoing on preexisting relationship with such 
prescriber.’’. 
(b) REPORT.—Not later than 3 years after the date 
of the enactment of this Act, the Secretary of Health and 
Human Services shall submit to Congress a report that con-
tains— 
(1) the number of individuals who were fur-
nished drugs in a manner that would constitute a 
violation of section 1877 of the Social Security Act 
(42 U.S.C. 1395nn) but for the amendment made by 
subsection (a); 
(2) an analysis of the change in expenditures 
under title XVIII of such Act (42 U.S.C. 1395 et seq.) 
attributable to such amendment; 
(3) a description of which drugs were furnished 
in a manner described in paragraph (1); and 
(4) such amendment’s impact on prices for such 
drugs. 
SEC. 3. MEDICARE COVERAGE OF EXTERNAL INFUSION 
PUMPS 
AND 
NON-SELF-ADMINISTRABLE 
HOME INFUSION DRUGS. 
Section 1861(n) of the Social Security Act (42 U.S.C. 
1395x(n)) is amended by adding at the end the following 
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new sentence: ‘‘Beginning with the first calendar quarter 
beginning on or after the date that is one year after the 
date of the enactment of the ‘Seniors’ Access to Critical 
Medications Act of 2024’, an external infusion pump and 
associated home infusion drug (as defined in subsection 
(iii)(3)(C)) or other associated supplies that do not meet 
the appropriate for use in the home requirement applied 
to the definition of durable medical equipment under sec-
tion 414.202 of title 42, Code of Federal Regulations (or 
any successor to such regulation) shall be treated as meeting 
such requirement if each of the following criteria is satis-
fied: 
‘‘(1) The prescribing information approved by 
the Food and Drug Administration for the home infu-
sion drug associated with the pump instructs that the 
drug should be administered by or under the super-
vision of a health care professional. 
‘‘(2) A qualified home infusion therapy supplier 
(as defined in subsection (iii)(3)(D)) administers or 
supervises the administration of the drug or biological 
in a safe and effective manner in the patient’s home 
(as defined in subsection (iii)(3)(B)). 
‘‘(3) The prescribing information described in 
paragraph (1) instructs that the drug should be in-
fused at least 12 times per year— 
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‘‘(A) intravenously or subcutaneously; or 
‘‘(B) at infusion rates that the Secretary de-
termines would require the use of an external in-
fusion pump.’’. 
SEC. 4. MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 1395iii(b)(1)) is amended by striking ‘‘$0’’ and in-
serting ‘‘$114,000,000’’. 
Amend the title so as to read: ‘‘A bill to amend title 
XVIII of the Social Security Act to clarify the application 
of the in-office ancillary services exception to the physi-
cian self-referral prohibition for covered outpatient drugs 
furnished under the Medicare program, and to provide 
coverage of external infusion pumps and non-self-admin-
istrable home infusion drugs under such program.’’. 
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Union Calendar No. 585 
118TH CONGRESS 
2D SESSION 
H. R. 5526 
[Report No. 118–691, Part I] 
A BILL 
To amend title XVIII of the Social Security Act to 
clarify the application of the in-office ancillary 
services exception to the physician self-referral 
prohibition for drugs furnished under the Medi-
care program. 
SEPTEMBER 19, 2024 
Reported from the Committee on Energy and Commerce 
with amendments 
SEPTEMBER 19, 2024 
Committee on Ways and Means discharged; committed to 
the Committee of the Whole House on the State of the 
Union and ordered to be printed 
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