IB 
Union Calendar No. 304 
116TH CONGRESS 
2D SESSION 
H. R. 4665 
[Report No. 116–327, Parts I and II] 
To amend title XVIII of the Social Security Act to provide coverage for 
certain vision items and services under part B of the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 11, 2019 
Ms. SCHRIER
(for herself, Mr. O’HALLERAN, Ms. SLOTKIN, and Ms. 
DELBENE) 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 
DECEMBER 6, 2019 
Reported from the Committee on Ways and Means with an amendment 
[Strike out all after the enacting clause and insert the part printed in italic] 
JANUARY 24, 2020 
Additional sponsors: Ms. CASTOR of Florida, Ms. NORTON, Mr. CUELLAR, and 
Mr. WELCH 
JANUARY 24, 2020 
Reported from the Committee on Energy and Commerce, 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 October 11, 2019] 
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A BILL 
To amend title XVIII of the Social Security Act to provide 
coverage for certain vision items and services under part 
B of 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 ‘‘Medicare Vision Act of 
2019’’. 
SEC. 2. PROVIDING COVERAGE FOR VISION CARE UNDER 
THE MEDICARE PROGRAM. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Secu-
rity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (GG), by striking ‘‘and’’ 
after the semicolon at the end; 
(2) in subparagraph (HH), by striking the pe-
riod at the end and adding ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(II) vision services (as defined in subsection 
(kkk));’’. 
(b) VISION SERVICES DEFINED.—Section 1861 of the 
Social Security Act (42 U.S.C. 1395x) is amended by add-
ing at the end the following new subsection: 
‘‘(kkk) VISION SERVICES.—The term ‘vision services’ 
means— 
‘‘(1) routine eye examinations to determine the 
refractive state of the eyes, including procedures per-
formed during the course of such examination; and 
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‘‘(2) contact lens fitting services; 
furnished on or after January 1, 2022, by or under the di-
rect supervision of an optometrist or ophthalmologist who 
is legally authorized to furnish such examinations, proce-
dures, or fitting services (as applicable) under State law 
(or the State regulatory mechanism provided by State law) 
of the State in which the examinations, procedures, or fit-
ting services are furnished.’’. 
(c) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the So-
cial Security Act (42 U.S.C. 1395l(a)(1)) is amend-
ed— 
(A) by striking ‘‘and’’ before ‘‘(CC)’’; and 
(B) by inserting before the semicolon at the 
end the following: ‘‘, and (DD) with respect to 
vision services (as defined in section 1861(kkk)), 
the amount paid shall be equal to 80 percent of 
the lesser of the actual charge or the amount de-
termined under the payment basis determined 
under section 1848’’. 
(2) LIMITS SPECIFIED.—Section 1834 of the So-
cial Security Act (42 U.S.C. 1395m) is amended by 
adding at the end the following new subsection: 
‘‘(x) LIMITATION FOR VISION SERVICES.—With respect 
to vision services (as defined in section 1861(kkk)) and an 
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