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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medicare Durable Medical Equipment
Access Act of 2007''.

SEC. 2. BENEFICIARY PROTECTIONS.

(a) Application of Quality Standards.--Section 1847(b)(2)(B) of the
Social Security Act (42 U.S.C. 1395w-3(b)(2)(B)) is amended to read as
follows:
''(B) Application of quality standards and receipt
of advice from oversight committee.--The Secretary may
not award any contracts under the competitive
acquisition program under this section unless--
''(i) the quality standards have been
implemented under section 1834(a)(20); and
''(ii) the Secretary has received advice
from the program oversight committee
established under subsection (c).''.
(b) Requiring Use of Exemptions.--Section 1847(a)(3) of such Act
(42 U.S.C. 1395w-3(a)(3)) is amended by striking ''may exempt'' and
inserting ''shall exempt''.
(c) Exemption of Smaller MSAs.--Section 1847(a)(3)(A) of such Act
(42 U.S.C. 1395w-3(a)(3)(A)) is amended by inserting ''(including any
metropolitan statistical area with a population of less than 500,000)''
after ''rural areas''.
(d) Application of Federal Advisory Committee Act (FACA) to Program
Advisory and Oversight Committee (PAOC).--Section 1847(c)(4) of such
Act (42 U.S.C. 1395w-3(c)(4)) is amended to read as follows:
''(4) Applicability of faca.--The provisions of the Federal
Advisory Committee Act (5 U.S.C. App.) shall apply to the
Committee.''.
(e) Effective Date.--The amendments made by this section shall be
effective as if included in the enactment of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173).

SEC. 3. SMALL SUPPLIER PROTECTIONS.

(a) Qualified Supplier Participation.--Section 1847(b) of the
Social Security Act (42 U.S.C. 1395w-3(b)) is amended--
(1) in paragraph (4)(A), by striking ''The Secretary may
limit'' and inserting ''Subject to paragraph (6)(D), the
Secretary may limit''; and
(2) in paragraph (6)(D), by adding at the end the
following: ''Such appropriate steps shall include permitting
all suppliers to continue to participate as suppliers at the
selected award price so long as they submit bids at less than
the fee schedule amount otherwise applicable to the items and
they otherwise comply with applicable program requirements.''.
(b) Restoration of Due Process.--Section 1847(b)(10) of such Act
(42 U.S.C. 1395w-3(b)(10)) is amended--
(1) by striking ''No administrative or judicial review''
and inserting ''Restoration of appeal rights''; and
(2) by striking ''There shall be no administrative or
judicial review under section 1869, section 1878, or otherwise
of'' and inserting ''Administrative and judicial review shall
only be available under section 1869 (and not otherwise) of''.
(c) Application of Requirement for Significant Savings.--Section
1847(a) of such Act (42 U.S.C. 1395w-3(a)) is amended--
(1) in paragraph (3)(B), by inserting ''of at least 10
percent'' after ''significant savings''; and
(2) in paragraph (1), by adding at the end the following
new subparagraph:
''(D) Requirement for significant savings.--The
Secretary shall not implement a program under this
section with respect to an item or service unless the
Secretary demonstrates a probability of achieving
significant savings of at least 10 percent, compared to
the fee schedule in effect on January 1, 2007, by
including the item or service in the program.''.
(d) Comparability Analysis.--Section 1834(a)(1) of such Act (42
U.S.C. 1395m(a)(1)) is amended--
(1) in subparagraph (F), by inserting ''subject to
subparagraph (G),'' after ''2009,''; and
(2) by adding at the end the following new subparagraphs:
''(G) Requirement for comparability analysis before
implementation.--The Secretary may not implement
subparagraph (F) with respect to the application of
rates in an area that is not a competitive acquisition
area under section 1847 unless the Secretary has
completed and published in the Federal Register a
comparability analysis to ensure the application is
appropriate. The comparability analysis shall include
at least an analysis of the relative costs of providing
the particular items and services in the respective
metropolitan statistical areas and an assessment of
whether application of the bid rate in an area that is
not a competitive acquisition area would adversely
impact beneficiary access to quality items and
services.
''(H) Application of comparability analysis
requirement to certain other part b items and
services.--Subparagraph (G) shall also apply to the
implementation of section 1847(a) with respect to items
described in paragraph (2)(B) or (2)(C) of such section
that are furnished on or after January 1, 2009.''.
(e) Effective Date.--The amendments made by this section shall be
effective as if included in the enactment of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173).

SEC. 4. REPORT ON QUALITY AND ACCESS IMPACT OF IMPLEMENTATION AT 10
INITIAL COMPETITIVE ACQUISITION AREAS.

(a) Analysis and Report.--After the Secretary of Health and Human
Services has fully implemented the initial 10 competitive acquisition
areas under section 1847 of the Social Security Act, the Secretary
shall conduct a complete analysis of the impact of competitive bidding
in those areas, including its impact on beneficiary access to quality
products and its impact on providers of items and services covered
under competition and shall submit a report to Congress on such
analysis.
(b) Moratorium on Further Implementation Until Congressional
Action.--
(1) In general.--Notwithstanding any other provision of
law, the Secretary shall not expand the coverage of competitive
acquisition programs under section 1847(a) of the Social
Security Act (42 U.S.C. 1395w-3(a)), or apply bid rates to non-
bid areas under such section, beyond the 10 competitive
acquisition areas identified under paragraph (1)(B)(i)(I) of
such section as of the date of the enactment of this Act,
unless specifically authorized by Congress after such date.
(2) Conforming reference.--Section 1847(a)(1)(B) of the
Social Security Act (42 U.S.C. 1395w-3(a)(1)(B)) is amended, in
the matter before clause (i), by striking ''The programs'' and
inserting ''Subject to section 4(b)(1) of the Medicare Durable
Medical Equipment Access Act of 2007, the programs''.
Output:
Medicare Durable Medical Equipment Access Act of 2007 - Amends title XVIII (Medicare) of the Social Security Act to prohibit the Secretary of Health and Human Services from awarding any contracts under the competitive durable medical equipment items and services acquisition program unless: (1) the quality standards have been implemented; and (2) the Secretary has received advice from the program oversight committee.

Requires the Secretary (who currently is authorized), in carrying out competitive acquisition programs, to exempt: (1) rural areas and areas with low population density within urban areas that are not competitive, unless there is a significant national market through mail order for a particular item or service; and (2) items and services for which the application of competitive acquisition is not likely to result in significant savings. Exempts smaller metropolitan statistical areas as well.

Modifies requirements for the protection of small suppliers in bidding and contracting. Requires the Secretary to permit all suppliers to continue to participate as suppliers at the selected award price so long as they submit bids at less than the fee schedule amount otherwise applicable and otherwise comply with program requirements.

Provides for appeal rights (currently denied).

Requires the Secretary to exempt from competitive acquisition requirements items and services for which the application of competitive acquisition is not likely to result in significant savings of at least 10%.

Prohibits the Secretary from implementing a program with respect to an item or service unless inclusion of the item or service will make significant savings of at least 10% probable, compared to the fee schedule in effect on January 1, 2007.

Prohibits the Secretary from implementing certain payment rate basis requirements for covered items furnished after January 1, 2009, with respect to an area that is not a competitive acquisition area, unless a comparability analysis has been completed and published.

Directs the Secretary, after fully implementing the initial 10 competitive acquisition areas, to analyze and report to Congress on the impact of competitive bidding in those areas.

Prohibits expanding the coverage of competitive acquisition programs, or applying bid rates to non-bid areas, beyond the 10 competitive acquisition areas, unless specifically authorized by Congress.