Medicare Demonstration of Coverage for Low Vision Devices Act of 2022
Bill: H.R.6848 | Sponsor: Rep. Maloney, Carolyn B. (D-NY)
Policy area: Health

Summary:
Medicare Demonstration of Coverage for Low Vision Devices Act of 2022
This bill requires the Centers for Medicare & Medicaid Services (CMS) to carry out a demonstration project to evaluate the fiscal impact of covering low-vision devices under Medicare in the same manner as Medicare coverage is provided for durable medical equipment. The bill defines low-vision device to mean a physician-prescribed device that magnifies, enhances, or otherwise augments or interprets visual images; the term does not include ordinary eyeglasses or contact lenses.
The bill appropriates $2.5 million for FY2022 and each of the next four fiscal years for the CMS to carry out the project.

To provide for a Medicare demonstration project to evaluate the fiscal 
  impact of covering low vision devices as durable medical equipment 
                 under part B of the Medicare program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Demonstration of Coverage 
for Low Vision Devices Act of 2022''.

SEC. 2. DEMONSTRATION PROJECT ON MEDICARE COVERAGE OF LOW VISION 
              DEVICES AS DURABLE MEDICAL EQUIPMENT.

    (a) Establishment of Demonstration Project.--
            (1) In general.--Beginning not later than 1 year after the 
        date of the enactment of this Act, the Secretary of Health and 
        Human Services (in this section referred to as the 
        ``Secretary'') shall commence a project (in this section 
        referred to as the ``demonstration project'') to demonstrate 
        and evaluate the fiscal impact of covering low vision devices 
        (including subsets of such devices) under part B of title XVIII 
        of the Social Security Act (42 U.S.C. 1395j et seq.) in the 
        same or similar manner as coverage is provided for durable 
        medical equipment under such part.
            (2) Low vision device defined.--In this section, the term 
        ``low vision device'' means a device, prescribed by a 
        physician, that magnifies, enhances, or otherwise augments or 
        interprets visual images irrespective of the size, form, or 
        technological features of such device and does not include 
        ordinary eyeglasses or contact lenses. In the previous 
        sentence, the term ``ordinary eyeglasses or contact lenses'' 
        means lenses that are intended to fully correct visual acuity 
        or fully eliminate refractive error.
    (b) Project Details.--
            (1) Eligible participants.--An individual enrolled under 
        such part is eligible to participate in the demonstration 
        project if an ophthalmologist or optometrist, after a clinical 
        evaluation, has determined and certifies through a prescription 
        that furnishing a low vision device to the individual is 
        medically necessary.
            (2) National scope and duration.--The demonstration project 
        shall be national in scope and shall be conducted for a period 
        of 5 years.
            (3) Project design.--The Secretary shall design the 
        demonstration project in a manner so as to provide a rich, 
        well-structured, and defined data set from which inferences 
        about the fiscal impact on the Federal Supplementary Medical 
        Insurance Trust Fund under section 1841 of the Social Security 
        Act (42 U.S.C. 1395t) resulting from the permanent coverage 
        under part B of title XVIII of the Social Security Act (42 
        U.S.C. 1395j et seq.) of low vision devices (including coverage 
        for subcategories or subsets of such devices) can be made using 
        appropriate statistical methods. To the maximum extent 
        possible, such demonstration project shall evaluate the fiscal 
        impact of permanent coverage under such part for the most 
        function-rich, most powerful, and most expensive low vision 
        devices.
            (4) Consultation.--In conducting the demonstration project 
        the Secretary shall consult with organizations of consumers 
        with vision loss and other stakeholder organizations.
    (c) Reports.--
            (1) Interim report.--Not later than 180 days after the last 
        day of the third year of the demonstration project, the 
        Secretary shall submit to the Committee on Finance of the 
        Senate and to the Committees on Ways and Means and Energy and 
        Commerce of the House of Representatives a report that 
        describes the progress and preliminary findings from the 
        demonstration project.
            (2) Final report.--Not later than 180 days after the last 
        day of the demonstration project and after solicitation and 
        consideration of formal written input on the project from 
        organizations representing consumers with vision loss and other 
        stakeholder organizations, the Secretary shall submit to such 
        Committees a final report on the project. Such report shall 
        include an evaluation of the fiscal impact on the Medicare 
        program under part B of title XVIII of the Social Security Act 
        (42 U.S.C. 1395 et seq.) of providing coverage of low vision 
        devices (including coverage for subcategories or subsets of 
        such devices) and such other findings and recommendations as 
        the Secretary deems appropriate.
    (d) Funding.--For fiscal year 2022 and for each of the four 
succeeding fiscal years, out of any funds in the Treasury not otherwise 
appropriated, $2,500,000 is appropriated to the Secretary to carry out 
the demonstration project.
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