individual, payment may be made under this part for only 
1 routine eye examination described in paragraph (1) of 
such section and 1 contact lens fitting service described in 
paragraph (2) of such section during a 2-year period.’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
(1) IN GENERAL.—Section 1848(j)(3) of the So-
cial Security Act (42 U.S.C. 1395w–4(j)(3)) is 
amended by inserting ‘‘(2)(II),’’ before ‘‘(3)’’. 
(2) 
BUDGET
NEUTRALITY.—Section 
1848(c)(2)(B)(iv) of the Social Security Act (42 
U.S.C. 1395–w(c)(2)(B)(iv)) is amended— 
(A) in subclause (III), by striking ‘‘and’’ at 
the end; 
(B) in subclause (IV), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subclause: 
‘‘(V) the amendment made by sec-
tion 2(d)(1) of the Medicare Vision Act 
of 2019 shall not be taken into account 
in applying clause (ii)(II) for 2022 
and 2023.’’. 
(e) COVERAGE OF CONVENTIONAL EYEGLASSES AND 
CONTACT LENSES.—Section 1861(s)(8) of the Social Secu-
rity Act (42 U.S.C. 1395x(s)(8)) is amended by striking ‘‘, 
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and including one pair of conventional eyeglasses or contact 
lenses furnished subsequent to each cataract surgery with 
insertion of an intraocular lens’’ and inserting ‘‘, including 
one pair of conventional eyeglasses or contact lenses fur-
nished subsequent to each cataract surgery with insertion 
of an intraocular lens, if furnished before January 1, 2022, 
and including conventional eyeglasses or contact lenses, 
whether or not furnished subsequent to such a surgery, if 
furnished on or after January 1, 2022’’. 
(f) SPECIAL PAYMENT RULES FOR EYEGLASSES AND 
CONTACT LENSES.— 
(1) LIMITATIONS.—Section 1834(h) of the Social 
Security Act (42 U.S.C. 1395m(h)) is amended by 
adding at the end the following new paragraph: 
‘‘(6) PAYMENT
LIMITATIONS
FOR
EYEGLASSES 
AND CONTACT LENSES.— 
‘‘(A) IN
GENERAL.—With respect to eye-
glasses and contact lenses furnished to an indi-
vidual on or after January 1, 2022, subject to 
subparagraph (B), payment may be made under 
this part only— 
‘‘(i) during a 2-year period, for either 
1 pair of eyeglasses (including lenses and 
frames) or a 2-year supply that is provided 
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in not more than 180-day increments of 
contact lenses; 
‘‘(ii) with respect to amounts attrib-
utable to the frames of such a pair of eye-
glasses and amounts attributable to contact 
lenses furnished during a year, in an 
amount not greater than— 
‘‘(I) for 2022, $100; and 
‘‘(II) for a subsequent year, the 
amount specified under this subpara-
graph for the previous year, increased 
by the percentage change in the con-
sumer price index for all urban con-
sumers during such previous year; 
‘‘(iii) for types of eyeglass lenses, and 
for types of contact lenses, as determined 
appropriate by the Secretary; 
‘‘(iv) if furnished pursuant to a writ-
ten order of a physician described in section 
1861(kkk); and 
‘‘(v) if during the 2-year period de-
scribed in clause (i), the individual did not 
already receive (as described in subpara-
graph (B)) one pair of conventional eye-
glasses or contact lenses subsequent to a cat-
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aract surgery with insertion of an intra-
ocular lens furnished during such period. 
‘‘(B) EXCEPTION.—With respect to a 2-year 
period described in subparagraph (A)(i), in the 
case of an individual who receives cataract sur-
gery with insertion of an intraocular lens, not-
withstanding subparagraph (A), payment may 
be made under this part for one pair of conven-
tional eyeglasses or contact lenses furnished sub-
sequent to such cataract surgery during such pe-
riod.’’. 
(2) APPLICATION
OF
COMPETITIVE
ACQUISI-
TION.— 
(A) IN GENERAL.—Section 1834(h)(1)(H) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395m(h)(1)(H)) is amended— 
(i) in the header by inserting ‘‘, EYE-
GLASSES, 
AND
CONTACT
LENSES’’ after 
‘‘ORTHOTICS’’; 
(ii) by inserting ‘‘and of eyeglasses and 
contact 
lenses 
described 
in 
paragraph 
(2)(D) of such section,’’ after ‘‘2009,’’ ; and 
(iii) in clause (i), by inserting ‘‘or 
such eyeglasses and contact lenses’’ after 
‘‘orthotics’’. 
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(B) CONFORMING AMENDMENT.— 
(i) IN GENERAL.—Section 1847(a)(2) 
of the Social Security Act (42 U.S.C. 
1395w–3(a)(2)) is amended by adding at 
the end the following new subparagraph: 
‘‘(D) EYEGLASSES AND CONTACT LENSES.— 
Eyeglasses and contact lenses for which payment 
would 
otherwise 
be 
made 
under 
section 
1834(h).’’. 
(ii) EXEMPTION
OF
CERTAIN
ITEMS 
FROM COMPETITIVE ACQUISITION.—Section 
1847(a)(7) of the Social Security Act (42 
U.S.C. 1395w–3(a)(7)) is amended by add-
ing at the end the following new subpara-
graph: 
‘‘(C) CERTAIN EYEGLASSES AND CONTACT 
LENSES.—Those items and services described in 
paragraph (2)(D) if furnished by a physician or 
other practitioner (as defined by the Secretary) 
to the physician’s or practitioner’s own patients 
as part of the physician’s or practitioner’s pro-
fessional service.’’. 
(g) EXCLUSION MODIFICATIONS.—Section 1862(a) of 
the Social Security Act (42 U.S.C. 1395y(a)) is amended— 
(1) in paragraph (1)— 
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(A) in subparagraph (O), by striking ‘‘and’’ 
at the end; 
(B) in subparagraph (P), by striking the 
semicolon at the end and inserting ‘‘, and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(Q) in the case of vision services (as defined in 
section 1861(kkk)) that are routine eye examinations 
and contact lens fitting services (as described in para-
graph (1) or (2), respectively, of such section), which 
are furnished more frequently than once during a 2- 
year period;’’; and 
(2) in paragraph (7)— 
(A) by inserting ‘‘(other than such an exam-
ination that is a vision service that is covered 
under section 1861(s)(2)(II))’’ after ‘‘eye exami-
nations’’; and 
(B) by inserting ‘‘(other than such a proce-
dure that is a vision service that is covered 
under section 1861(s)(2)(II))’’ after ‘‘refractive 
state of the eyes’’. 
SEC. 3. IMPLEMENTATION FUNDING. 
The Secretary of Health and Human Services shall 
provide for the transfer from the Federal Supplementary 
Medical Insurance Trust Fund under section 1841 of the 
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Social Security Act (42 U.S.C. 1395t) to the Centers for 
Medicare & Medicaid Services Program Management Ac-
count for the period of 2020 through 2024 of such sums as 
may be necessary for purposes of implementing the amend-
ments made by section 2. 
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Union Calendar No. 304 
116TH CONGRESS 
2D SESSION 
H. R. 4665 
[Report No. 116–327, Parts I and II] 
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. 
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 
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