IIB 
118TH CONGRESS 
2D SESSION 
H. R. 5526 
IN THE SENATE OF THE UNITED STATES 
SEPTEMBER 24, 2024 
Received; read twice and referred to the Committee on Finance 
AN ACT 
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 covered out-
patient drugs furnished under the Medicare program, 
and to provide coverage of external infusion pumps and 
non-self-administrable home infusion drugs under such 
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 
Security Act (42 U.S.C. 1395nn(b)(2)) is amended by 
adding at the end the following new sentence: ‘‘With re-
spect to services described in subsection (h)(6)(J) con-
sisting 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 fur-
nished in accordance with subparagraph (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 cou-
rier service, but only if, during the 1-year period ending 
on the date such drugs were so furnished, such individual 
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had a face-to-face encounter with the prescriber of such 
drugs (not including any such encounter conducted via 
telehealth), and only if such prescriber (or another physi-
cian 
or 
practitioner 
(as 
described 
in 
section 
1842(b)(18)(C)) in the same practice as such prescriber 
(as determined by tax identification number)) furnished 
to such individual, during such 1-year period, another item 
or service for which payment was made under this title, 
and only if such individual has an ongoing 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 
contains— 
(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 
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(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 
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 meet-
ing such requirement if each of the following criteria is 
satisfied: 
‘‘(1) The prescribing information approved by 
the Food and Drug Administration for the home in-
fusion drug associated with the pump instructs that 
the drug should be administered by or under the su-
pervision of a health care professional. 
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‘‘(2) A qualified home infusion therapy supplier 
(as defined in subsection (iii)(3)(D)) administers or 
supervises the administration of the drug or biologi-
cal 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— 
‘‘(A) intravenously or subcutaneously; or 
‘‘(B) at infusion rates that the Secretary 
determines would require the use of an external 
infusion 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’’. 
Passed the House of Representatives September 23, 
2024. 
Attest: 
KEVIN F. MCCUMBER, 
Clerk. 
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