I 
110TH CONGRESS 
1ST SESSION H. R. 1845 
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 
MARCH 29, 2007 
Mr. TANNER (for himself, Mr. HOBSON, and Mr. ROSS) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee 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 2007’’. 
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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-
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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 all suppliers 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.’’. 
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(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 
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fee schedule in effect on January 1, 2007, 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. 
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‘‘(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). 
SEC. 4. REPORT ON QUALITY AND ACCESS IMPACT OF IM-
PLEMENTATION AT 10 INITIAL COMPETITIVE 
ACQUISITION AREAS. 
(a) ANALYSIS AND REPORT.—After the Secretary of 
Health and Human Services has fully implemented the ini-
tial 10 competitive acquisition areas under section 1847 
of the Social Security Act, the Secretary shall conduct a 
complete analysis of the impact of competitive bidding in 
those areas, including its impact on beneficiary access to 
quality products and its impact on providers of items and 
services covered under competition and shall submit a re-
port to Congress on such analysis. 
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(b) MORATORIUM ON FURTHER IMPLEMENTATION 
UNTIL CONGRESSIONAL ACTION.— 
(1) IN GENERAL.—Notwithstanding any other 
provision of law, the Secretary shall not expand the 
coverage of competitive acquisition programs under 
section 1847(a) of the Social Security Act (42 
U.S.C. 1395w–3(a)), or apply bid rates to non-bid 
areas under such section, beyond the 10 competitive 
acquisition 
areas 
identified 
under 
paragraph 
(1)(B)(i)(I) of such section as of the date of the en-
actment of this Act, unless specifically authorized by 
Congress after such date. 
(2) 
CONFORMING
REFERENCE.—Section 
1847(a)(1)(B) of the Social Security Act (42 U.S.C. 
1395w–3(a)(1)(B)) is amended, in the matter before 
clause (i), by striking ‘‘The programs’’ and inserting 
‘‘Subject to section 4(b)(1) of the Medicare Durable 
Medical Equipment Access Act of 2007, the pro-
grams’’. 
Æ 
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