I 
109TH CONGRESS 
2D SESSION 
H. R. 4994 
To amend title XVIII of the Social Security Act to exempt complex rehabilita-
tion products and assistive technology products from the Medicare com-
petitive acquisition program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 16, 2006 
Mr. LEWIS of Kentucky introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Com-
mittee 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 
A BILL 
To amend title XVIII of the Social Security Act to exempt 
complex rehabilitation products and assistive technology 
products from the Medicare competitive acquisition pro-
gram. 
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 Access to 
Complex Rehabilitation and Assistive Technology Act of 
2006’’. 
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SEC. 2. EXEMPTION OF COMPLEX REHABILITATION AND 
ASSISTIVE TECHNOLOGY FROM THE MEDI-
CARE COMPETITIVE ACQUISITION PROGRAM. 
(a) IN GENERAL.—Section 1847(a) of the Social Se-
curity Act (42 U.S.C. 1395w-3(a)) is amended— 
(1) in paragraph (2)(A)— 
(A) by striking ‘‘but excluding’’ and all 
that follows through ‘‘Cosmetic Act.’’ and in-
serting ‘‘but excluding—’’; and 
(B) by adding at the end the following new 
clauses: 
‘‘(i) class III devices under the Fed-
eral Food, Drug, and Cosmetic Act; and 
‘‘(ii) complex rehabilitation products 
and assistive technology products (de-
scribed in paragraph (7)(A)) that are pre-
scribed by a physician and provided by a 
supplier that is accredited by an inde-
pendent accreditation organization des-
ignated under section 1834(a)(20)(B).’’; 
and 
(2) by adding at the end the following new 
paragraph: 
‘‘(7) COMPLEX
REHABILITATION
PRODUCTS 
AND
ASSISTIVE
TECHNOLOGY
PRODUCTS
DE-
SCRIBED.— 
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‘‘(A) IN GENERAL.—For purposes of para-
graph (2)(A)(ii), complex rehabilitation prod-
ucts and assistive technology products described 
in this subparagraph are medically necessary 
adaptive seating, positioning, and mobility de-
vices and speech generating devices that are 
evaluated, fitted, configured, adjusted, or pro-
grammed to meet the specific and unique needs 
of an individual with a primary diagnosis re-
sulting from injury or trauma or which is neu-
romuscular in nature. Such a primary diagnosis 
includes spinal cord injury, traumatic brain in-
jury, cerebral palsy, muscular dystrophy, spinal 
muscular atrophy, spina bifida, amyotrophic lat-
eral sclerosis, multiple sclerosis, or any other 
disease or disability identified by the Secretary 
as requiring the use of such devices. 
‘‘(B) ESTABLISHMENT
OF
MEDICAL
NE-
CESSITY.—For purposes of subparagraph (A), 
in establishing medical necessity of a device de-
scribed in such subparagraph for the treatment 
of an individual, the Secretary shall consider 
whether the device is expected to be necessary 
for such treatment taking into account the di-
agnosis, prognosis, and functional need of the 
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individual and the expected progression of the 
disease or disability involved.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) 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). 
Æ 
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