I 
109TH CONGRESS 
1ST SESSION H. R. 3559 
To amend part B of title XVIII of the Social Security Act to assure access 
to durable medical equipment under the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 28, 2005 
Mr. HOBSON (for himself and Mr. TANNER) 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 subse-
quently 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 part B of title XVIII of the Social Security 
Act to assure access to durable medical equipment under 
the Medicare Program. 
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 ‘‘Medicare Durable 
Medical Equipment Access Act of 2005’’.
SEC. 2. BENEFICIARY PROTECTIONS. 
(a) APPLICATION OF QUALITY STANDARDS.—Section 
1847(b)(2)(B) of the Social Security Act (42 U.S.C. 
1395w–3(b)(2)(B)) is amended to read as follows: 
‘‘(B) APPLICATION
OF
QUALITY
STAND-
ARDS AND RECEIPT OF ADVICE FROM OVER-
SIGHT
COMMITTEE.—The Secretary may not 
award any contracts under the competitive ac-
quisition program under this section unless— 
‘‘(i) the quality standards have been 
implemented under section 1834(a)(20); 
and 
‘‘(ii) the Secretary has received advice 
from the program oversight committee es-
tablished under subsection (c).’’. 
(b) REQUIRING
USE
OF
EXEMPTIONS.—Section 
1847(a)(3) of such Act (42 U.S.C. 1395w–3(a)(3)) is 
amended by striking ‘‘may exempt’’ and inserting ‘‘shall 
exempt’’. 
(c) EXEMPTION
OF
SMALLER
MSAS.—Section 
1847(a)(3)(A) of such Act (42 U.S.C. 1395w–3(a)(3)(A)) 
is amended by inserting ‘‘(including any metropolitan sta-
tistical area with a population of less than 500,000)’’ after 
‘‘rural areas’’. 
(d) APPLICATION
OF FEDERAL ADVISORY COM-
MITTEE ACT (FACA) TO PROGRAM ADVISORY AND OVER-
SIGHT COMMITTEE (PAOC).—Section 1847(c)(4) of such 
Act (42 U.S.C. 1395w–3(c)(4)) is amended to read as fol-
lows: 
‘‘(4) APPLICABILITY OF FACA.—The provisions 
of the Federal Advisory Committee Act (5 U.S.C. 
App.) shall apply to the Committee.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall be effective as if included in the enact-
ment of the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 (Public Law 108–173). 
SEC. 3. SMALL SUPPLIER PROTECTIONS. 
(a) QUALIFIED SUPPLIER PARTICIPATION.—Section 
1847(b) of the Social Security Act (42 U.S.C. 1395w– 
3(b)) is amended— 
(1) in paragraph (4)(A), by striking ‘‘The Sec-
retary may limit’’ and inserting ‘‘Subject to para-
graph (6)(D), the Secretary may limit’’; and 
(2) in paragraph (6)(D), by adding at the end 
the following: ‘‘Such appropriate steps shall include 
permitting suppliers that are classified as small busi-
nesses under the Small Business Act to continue to 
participate as suppliers at the selected award price 
so long as they submit bids at less than the fee 
schedule amount otherwise applicable to the items
and they otherwise comply with applicable program 
requirements.’’. 
(b) RESTORATION
OF
DUE
PROCESS.—Section 
1847(b)(10) of such Act (42 U.S.C. 1395w–3(b)(10)) is 
amended— 
(1) by striking ‘‘NO ADMINISTRATIVE OR JUDI-
CIAL REVIEW’’ and inserting ‘‘RESTORATION OF AP-
PEAL RIGHTS’’; and 
(2) by striking ‘‘There shall be no administra-
tive or judicial review under section 1869, section 
1878, or otherwise of’’ and inserting ‘‘Administra-
tive and judicial review shall only be available under 
section 1869 (and not otherwise) of’’. 
(c) APPLICATION OF REQUIREMENT FOR SIGNIFI-
CANT SAVINGS.—Section 1847(a) of such Act (42 U.S.C. 
1395w–3(a)) is amended— 
(1) in paragraph (3)(B), by inserting ‘‘of at 
least 10 percent’’ after ‘‘significant savings’’; and 
(2) in paragraph (1), by adding at the end the 
following new subparagraph: 
‘‘(D) REQUIREMENT
FOR
SIGNIFICANT 
SAVINGS.—The Secretary shall not implement a 
program under this section with respect to an 
item or service unless the Secretary dem-
onstrates a probability of achieving significant
savings of at least 10 percent, compared to the 
fee schedule in effect on January 1, 2006, by 
including the item or service in the program.’’. 
(d) COMPARABILITY ANALYSIS.—Section 1834(a)(1) 
of such Act (42 U.S.C. 1395m(a)(1)) is amended— 
(1) in subparagraph (F), by inserting ‘‘subject 
to subparagraph (G),’’ after ‘‘2009,’’; and 
(2) by adding at the end the following new sub-
paragraphs: 
‘‘(G) REQUIREMENT FOR COMPARABILITY 
ANALYSIS
BEFORE
IMPLEMENTATION.—The 
Secretary may not implement subparagraph (F) 
with respect to the application of rates in an 
area that is not a competitive acquisition area 
under section 1847 unless the Secretary has 
completed and published in the Federal Reg-
ister a comparability analysis to ensure the ap-
plication is appropriate. The comparability 
analysis shall include at least an analysis of the 
relative costs of providing the particular items 
and services in the respective metropolitan sta-
tistical areas and an assessment of whether ap-
plication of the bid rate in an area that is not 
a competitive acquisition area would adversely
impact beneficiary access to quality items and 
services. 
‘‘(H) APPLICATION
OF
COMPARABILITY 
ANALYSIS
REQUIREMENT
TO
CERTAIN
OTHER 
PART B ITEMS AND SERVICES.—Subparagraph 
(G) shall also apply to the implementation of 
section 1847(a) with respect to items described 
in paragraph (2)(B) or (2)(C) of such section 
that are furnished on or after January 1, 
2009.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall be effective as if included in the enact-
ment of the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 (Public Law 108–173).
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