I 
113TH CONGRESS 
1ST SESSION H. R. 3320 
To ensure appropriate coverage of ventricular assist devices under the Medi-
care program under title XVIII of the Social Security Act, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 23, 2013 
Mr. BUCSHON introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To ensure appropriate coverage of ventricular assist devices 
under the Medicare program under title XVIII of the 
Social Security Act, and for other purposes. 
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 Ventricular 
Assist Device Access Act of 2013’’. 
SEC. 2. FINDINGS; PURPOSE. 
(a) FINDINGS.—Congress finds the following: 
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(1) Ventricular assistance devices are mechan-
ical blood pumps that surgeons attach to a damaged 
or weakened native heart to assist in pumping blood. 
(2) Under its coverage policy as of the date of 
the enactment of this Act, the Medicare program 
covers ventricular assist devices for Medicare bene-
ficiaries that meet certain criteria after open-heart 
surgery, that are approved and listed as candidates 
for heart transplant by a Medicare-approved heart 
transplant center, and for those who are not eligible 
for a heart transplant. 
(3) The Medicare program does not currently 
cover Medicare beneficiaries for ventricular assist de-
vices who are— 
(A) undergoing an evaluation to determine 
their candidacy for heart transplantation; or 
(B) potential heart transplant candidates, 
but who are currently not eligible for heart 
transplantation because of a contraindication 
that may be favorably modified by the use of a 
ventricular assist device. 
(4) Approximately 40 percent of patients who 
receive a ventricular assist device are not eligible for 
a heart transplant initially, but may become eligible 
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as the ventricular support improves their overall 
health. 
(b) PURPOSE.—The purpose of this Act is to ensure 
Medicare beneficiaries with heart failure have appropriate 
access to ventricular assist devices. 
SEC. 3. REVISION OF MEDICARE VENTRICULAR ASSIST DE-
VICE NATIONAL COVERAGE POLICY. 
(a) 
IN
GENERAL.—Notwithstanding 
section 
1862(a)(1)(A) of the Social Security Act (42 U.S.C. 
1395y(a)(1)(A)) or any other provision of law, the Sec-
retary of Health and Human Services (in this section re-
ferred to as the ‘‘Secretary’’) shall revise the Medicare na-
tional coverage determination (as defined in section 
1869(f)(1)(B) of the Social Security Act (42 U.S.C. 
1395ff(f)(1)(B))) relating to coverage of ventricular assist 
devices to extend the coverage of such devices under title 
XVIII of the Social Security Act applied as of the date 
of the enactment of this Act with respect to individuals 
approved for heart transplantation to also apply to— 
(1) individuals who are undergoing an evalua-
tion to determine candidacy for heart transplan-
tation; and 
(2) individuals who would be potential heart 
transplant candidates, but are not so eligible because 
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of a contraindication that may be favorably modified 
by the use of a ventricular assist device. 
(b) CONSTRUCTION.—Nothing in this section shall be 
construed— 
(1) to limit coverage of ventricular assist de-
vices for Medicare beneficiaries who meet the Medi-
care criteria for coverage of ventricular assist devices 
as of the date of enactment of this Act; or 
(2) as preventing the Secretary from expanding 
its coverage decision beyond the coverage required 
under this section. 
(c) REVISION OF NATIONAL COVERAGE DECISION; 
EFFECTIVE DATE.— 
(1) REVISION OF NATIONAL COVERAGE DECI-
SION.—The Secretary shall use the processes de-
scribed in section 1862(l) of the Social Security Act 
(42 U.S.C. 1395y(l)) to revise its national coverage 
determination relating to ventricular assist devices 
to incorporate the requirements of this section. 
(2) EFFECTIVE
DATE.—The revised coverage 
decision described in paragraph (1) shall apply to 
ventricular assist devices furnished on or after the 
date that is 30 days after the date of the enactment 
of this Act, regardless of the date on which the Sec-
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retary completes the process required under such 
paragraph. 
Æ 
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