,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #caab  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,septemb] #ag1        
#bjac,mr4 ,?ompson ( ,p5nsylvania 7=    
himself & ,mr4 ,?ompson ( ,cali=nia7    
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to modify !      
designation ( accr$itation organizations
 = or?otics & pro/hetics1 to apply      
accr$itation & lic5sure requirem5ts to  
suppli]s ( su* devices & items =        
purposes ( paym5t "u ! ,m$ic>e program1 
& to modify ! paym5t rules = su* devices
 & items "u su* program to acc\nt =     
practition] qualifications & complexity 
( c>e1 & = o!r purposes4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,m$ic>e 
,or?otics & ,pro/hetics ,improvem5t ,act

 ( #bjac4  #b4 ,modification (          
requirem5ts applicable "u m$ic>e to     
designation ( accr$itation organizations
 = suppli]s ( or?otics & pro/hetics  7a7
 ,9 g5]al ,section #ahcd7;a77#bj77;,b7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciem7a77#bj77;,b77 is am5d$-- 7#a7 by
 /rik+ organizations4--,n lat] ?an &    
ins]t+3 organizations4-- 7i7 ,9 g5]al   
,subject to clause 7ii71 n lat] ?an  2 &
  7#b7 by add+ aft] clause 7i71 z add$  
by p>agraph 7#a71 ! foll[+ new clauses3 
7ii7 ,special requirem5ts = accr$itation
 ( suppli]s ( or?otics & pro/hetics ,=  
purposes ( apply+ quality /&>ds "u      
subp>agraph 7,a7 = suppli]s 7o!r ?an    
suppli]s describ$ 9 clause 7iii77 (     
items & s]vices describ$ 9 subp>agraph  
7,d77ii71 ! ,secret>y %all designate &  
approve an indep5d5t accr$itation       
organization "u clause 7i7 only if su*  
organization is a ,bo>d or program      
describ$ 9 subsection 7h77#a77;,f77iv74 
,n lat] ?an ,janu>y #a1 #bjad1 !        
,secret>y %all ensure t at lea/ "o      

indep5d5t accr$itation organization is  
designat$ & approv$ 9 accordance ) ?is  
clause4  7iii7 ,exception ,suppli]s     
describ$ 9 ?is clause are physicians1   
occupational !rapi/s1 or physical       
!rapi/s :o are lic5s$ or o!rwise        
regulat$ by ! ,/ate 9 :i* !y are        
practic+ & :o receive paym5t "u ?is     
title1 includ+ regulations promulgat$   
pursuant to ?is subsection4  4  7b7     
,effective date ,an organization mu/    
satisfy ! requirem5t ( section          
#ahcd7;a77#bj77;,b77ii71 z add$ by      
subsection 7a77#b71 n lat] ?an ,janu>y  
#a1 #bjad1 reg>dless ( :e!r su*         
organization is designat$ or approv$ z  
an indep5d5t accr$itation organization  
be=e1 on1 or aft] ! date ( ! enactm5t ( 
?is ,act4  #c4 ,application ( exi/+     
accr$itation & lic5sure requirem5ts to  
c]ta9 pro/hetics & cu/om-fabricat$ or   
cu/om-fitt$ or?otics  7a7 ,9 g5]al      
,section #ahcd7;h77#a77;,f7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciem7h77#a77;,f77 is am5d$-- 7#a7 9 ! 

head+1 by ins]t+ or cu/om-fitt$ aft]    
cu/om-fabricat$2  7#b7 9 clause 7i71 by 
/rik+ an item ( cu/om-fabricat$ or?otics
 describ$ 9 clause 7ii7 or = an item (  
pro/hetics unless su* item is & ins]t+  
an item ( or?otics or pro/hetics1       
includ+ an item ( cu/om-fabricat$       
or?otics describ$ 9 clause 7ii71 unless 
su* item is2  7#c7 9 clause 7ii77,,ii71 
by /rik+ a li/ ( items to :i* ?is       
subp>agraph applies & ins]t+ a li/ (    
items = purposes ( clause 7i72  7#d7 9  
clause 7iii77,,iii71 by /rik+ to provide
 or manage ! provision ( pro/hetics &   
cu/om-design$ or -fabricat$ or?otics &  
ins]t+ to provide or manage ! provision 
( or?otics & pro/hetics 7& cu/om-design$
 or -fabricat$ or?otics1 9 ! case ( an  
item describ$ 9 clause 7ii772 &  7#e7 by
 add+ at ! end ! foll[+ new clause3  7v7
 ,exemption ( (f-!-%elf or?otics includ$
 9 a competitive acquisition program    
,?is subp>agraph %all n apply to an item
 ( or?otics describ$ 9 p>agraph         
7#b77;,c7 ( section #ahdg7;a7 furni%$ on

 or aft] ,janu>y #a1 #bjad1 t is includ$
 9 a competitive acquisition program 9 a
 competitive acquisition area "u su*    
section4  4  7b7 ,effective date ,!     
am5dm5ts made by subsection 7a7 %all    
apply to or?otics & pro/hetics furni%$  
on or aft] ,janu>y #a1 #bjad4  #d4      
,eligibility = m$ic>e paym5t = or?otics 
& pro/hetics bas$ on suppli]            
qualifications & complexity ( c>e       
,section #ahcd7;h7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciem7h77 is      
am5d$-- 7#a7 9 p>agraph 7#a77;,f77iii71 
9 ! matt] prec$+ subclause 7,i71 by     
/rik+ o!r individual :o & ins]t+ o!r    
individual :o1 ) respect to a category (
 or?otics & pro/hetics c>e describ$ 9   
clause 7i71 7ii71 7iii71 7iv71 or 7v7 ( 
p>agraph 7#e77;,c7 furni%$ on or aft]   
,janu>y #a1 #bjad1 & subject to p>agraph
 7#e77;,a71 satisfies all applicable    
crit]ia ( ! suppli] qualification       
designation = su* category describ$ 9 ! 
respective clause1 & :o2  7#b7 9        
p>agraph 7#a77;,f77iv71 by ins]t+ be=e !

 p]iod ! foll[+3 &1 ) respect to a      
category ( or?otics & pro/hetics c>e    
describ$ 9 clause 7i71 7ii71 7iii71     
7iv71 or 7v7 ( p>agraph 7#e77;,c7       
furni%$ on or aft] ,janu>y #a1 #bjad1 & 
subject to p>agraph 7#e77;,a71 satisfies
 all applicable crit]ia ( ! provid]     
qualification designation = su* category
 describ$ 9 ! respective clause2 &  7#c7
 by add+ at ! end ! foll[+ new p>agraph3
  7#e7 ,eligibility = paym5t bas$ on    
suppli] qualifications & complexity (   
c>e  7,a7 ,consid]ations = eligibility =
 paym5ts  7i7 ,9 g5]al ,9 apply+ clauses
 7iii7 & 7iv7 ( p>agraph 7#a77;,f7 =    
purposes ( det]m9+ :e!r paym5t may be   
made "u ?is subsection = or?otics &     
pro/hetics furni%$ on or aft] ,janu>y   
#a1 #bjad1 ! ,secret>y %all take into   
acc\nt ! complexity ( ! respective item 
&1 subject to clauses 7ii71 7iii71 &    
7iv71 ! qualifications ( ! individual or
 entity furni%+ & fabricat+ su*         
respective item 9 accordance ) ?is      
p>agraph4  7ii7 ,individual & entities  

exempt$ f suppli] qualification         
designation crit]ia ,) respect to an    
item ( or?otics or pro/hetics describ$ 9
 clause 7ii71 7iii71 7iv7 or 7v7 (      
subp>agraph 7,c71 any crit]ia = !       
suppli] qualification designations "u   
su* respective clause1 includ+          
application ( subp>agraph 7,d71 %all n  
apply to physicians1 occupational       
!rapi/s1 or physical !rapi/s :o are     
lic5s$ or o!rwise regulat$ by ! ,/ate 9 
:i* !y are practic+ & :o receive paym5t 
"u ?is title1 includ+ regulations       
promulgat$ pursuant to ?is subsection1 =
 ! provision ( or?otics & pro/hetics4   
7iii7 ,suppli]s m$ic>e-eligible prior to
 ,janu>y #a1 #bjad1 exempt$ ,9 ! case ( 
a qualifi$ suppli] :o is eligible to    
receive paym5t "u ?is title be=e ,janu>y
 #a1 #bjad-- 7,i7 ) respect to an item (
 or?otics or pro/hetics describ$ 9      
clause 7i7 ( subp>agraph 7,c71 any      
crit]ia = ! provid] qualification       
designations "u su* clause1 includ+     
application ( subp>agraph 7,d71 %all n  

apply to su* suppli]1 respectively1 = ! 
furni%+ or fabrication ( su* an item s  
describ$2 &  7,,ii7 ) respect to an item
 ( or?otics or pro/hetics describ$ 9    
clause 7ii71 7iii71 or 7iv7 (           
subp>agraph 7,c71 any crit]ia = !       
suppli] qualification designations "u ! 
respective clause 7or a subsequ5t clause
 ( su* subp>agraph71 includ+ application
 ( subp>agraph 7,d71 %all n apply to su*
 suppli]1 respectively1 = ! furni%+ or  
fabrication ( su* an item describ$ 9 su*
 respective 7or su* subsequ5t7 clause4  
7iv7 ,delay$ application ( c]ta9 suppli]
 qualification designation crit]ia ,!   
suppli] qualification designations "u   
clauses 7i71 7ii71 & 7iii7 ( subp>agraph
 7,c71 includ+ ! application (          
subp>agraph 7,d7 to su* clauses1 %all n 
be tak5 into acc\nt ) respect to paym5t 
made "u ?is subsection = or?otics &     
pro/hetics furni%$ be=e ,janu>y #a1     
#bjae4  7v7 ,modifications ,! ,secret>y 
%all1 9 consultation ) ! ,bo>ds &       
programs describ$ 9 p>agraph            

7#a77;,f77iv71 p]iodically review !     
crit]ia = ! suppli] qualification       
designation "u subp>agraph              
7,c77i77,,iii7 & may implem5t by        
regulation any modifications to su*     
crit]ia1 z det]m9$ appropriate 9        
accordance ) su* consultation4 ,any su* 
modification %all take effect no e>li]  
?an ,janu>y #a1 #bjaf4  7,b7 ,assignm5t 
( bill+ codes ,= purposes ( subp>agraph 
7,a71 ! ,secret>y1 9 consultation )     
repres5tatives ( ! fields ( occupational
 !rapy1 physical !rapy1 or?otics1 &     
pro/hetics %all utilize & incorporate ! 
set ( ,l-codes li/$1 z ( ! date ( !     
enactm5t ( ?is p>agraph1 9 ! ,c5t]s =   
,m$ic>e  ,m$icaid ,s]vices docum5t      
entitl$ ,transmittal #fef 7,,cms ,pub4  
#ajj-jd1 ,*ange ,reque/ #ciei1 ,augu/   
#ai1 #bjje74 ,transmittal #fef %all be !
 controll+ s\rce ( category1 product1 & 
code assignm5ts = ! or?otics &          
pro/hetics c>e describ$ 9 ea* ( clauses 
7i7 ?r\gh 7v7 ( subp>agraph 7,c7 us+ !  
suppli] qualification designation = ea* 

,,hcpcs code z /at$ 9 su* docum5t4 ,9 ! 
case t ,transmittal #fef is updat$1     
reissu$1 or replac$ by a subsequ5t      
docum5t1 ! previ\s s5t5ce %all be appli$
 ) respect to ! mo/ rec5t update1       
reissuance1 or replacem5t ( su* docum5t4
  7,c7 ,categories ( or?otic & pro/hetic
 c>e describ$  7i7 ,cu/om-fabricat$ limb
 pro/hetics category ,! category (      
or?otic & pro/hetic c>e describ$ 9 ?is  
clause is a category = artificial legs &
 arms1 includ+ replacem5ts 7z describ$ 9
 section #ahfa7s77#i77 t are made f     
detail$ measurem5ts1 images1 or models 9
 accordance ) a prescription & t c only 
be utiliz$ by a specific int5d$ pati5t &
 = :i* paym5t is made "u ?is "p4 ,!     
suppli] qualification designation = !   
category %all reflect ea* ( ! foll[+1 9 
accordance ) subp>agraph 7,d73 7,i7 ,!  
category ( c>e involves ! highe/ level (
 complexity ) sub/antial cl9ical risk4  
7,,ii7 ,! category ( c>e requires a     
suppli] :o satisfies any ( ! education  
requirem5ts describ$ 9 subclause        

7,,iii71 has complet$ a pro/hetic       
resid5cy accr$it$ by ! ,national        
,commission on ,or?otic & ,pro/hetic    
,education 7,,ncope71 & is c]tifi$ or   
lic5s$ 9 pro/hetics to ensure !         
compreh5sive provision ( pro/hetic c>e4 
7,,iii7 ,! category ( c>e requires a    
suppli] :o has complet$ any ( ! foll[+  
education requirem5ts3 7aa7 ,a ba*elor's
 degree or ma/]'s degree 9 pro/hetics z 
(f]$ by educational in/itutions accr$it$
 by ! ,commission on ,accr$itation (    
,alli$ ,heal? ,education ,programs4     
7bb7 ,a ba*elor's degree1 plus a        
c]tificate 9 pro/hetics z (f]$ by       
educational in/itutions accr$it$ by !   
,commission on ,accr$itation ( ,alli$   
,heal? ,education ,programs4  7cc7 ,a   
=eign degree det]m9$ by ! ,_w ,education
 ,s]vice to be equival5t to an          
educational program 9 pro/hetics        
accr$it$ by ! ,commission on            
,accr$itation ( ,alli$ ,heal? ,education
 ,programs4  7ii7 ,cu/om-fabricat$      
or?otics categry ,! category ( or?otics 

& pro/hetics c>e describ$ 9 ?is clause  
is a category = cu/om-fabricat$ or?otics
 t are made f detail$ measurem5ts1      
images1 or models 9 accordance ) a      
prescription & t c only be utiliz$ by a 
specific int5d$ pati5t4 ,! suppli]      
qualification designation = ! category  
%all reflect ! foll[+1 9 accordance )   
subp>agraph 7,d73 7,i7 ,! category ( c>e
 involves ! highe/ level ( complexity ) 
sub/antial cl9ical risk4  7,,ii7 ,!     
category ( c>e requires a suppli] :o    
satisfies any ( ! education requirem5ts 
describ$ 9 clause 7i77,,iii7 7except t =
 purposes ( ?is subclause su* clause    
%all be appli$ by sub/itut+ ! t]m       
or?otics ea* place ! t]m pro/hetics is  
us$71 has complet$ an or?otic resid5cy  
accr$it$ by ! ,national ,commission on  
,or?otic & ,pro/hetic ,education1 & is  
c]tifi$ or lic5s$ 9 or?otics to ensure !
 appropriate provision ( or?otic c>e4   
7iii7 ,cu/om-fitt$ high or?otics        
category ,! category ( or?otic c>e      
describ$ 9 ?is clause is a category =   

prefabricat$ or?otics t are manufactur$ 
) no specific pati5t 9 m9d1 b t are     
appropriately siz$1 adapt$1 modifi$1 &  
configur$ 7) ! requir$ tools & equipm5t7
 to a specific pati5t 9 accordance ) a  
prescription4 ,! suppli] qualification  
designation = ! category %all reflect ! 
foll[+1 9 accordance ) subp>agraph 7,d73
 7,i7 ,! category ( c>e involves mod]ate
 to high complexity ) sub/antial cl9ical
 risk4  7,,ii7 ,! category ( c>e        
requires a practition] :o ei!r-- 7aa7   
satisfies any ( ! education requirem5ts 
describ$ 9 clause 7i77,,iii71 except t =
 purposes ( ?is subclause su* clause    
%all be appli$ by sub/itut+ ! t]m       
or?otics ea* place ! t]m pro/hetics is  
us$2 or  7bb7 is c]tifi$ or lic5s$ 9    
or?otics to ensure ! appropriate        
provision ( or?otic c>e )9 !            
practition]'s normal scope ( practice4  
7iv7 ,cu/om-fitt$ l[ or?otics category  
,! category ( or?otics & pro/hetics c>e 
describ$ 9 ?is clause is a category =   
prefabricat$ or?otics t are manufactur$ 

) no specific pati5t 9 m9d1 b t are     
appropriately siz$ & adju/$ to a        
specific pati5t 9 accordance ) a        
prescription4 ,! suppli] qualification  
designation = ! category %all reflect ! 
foll[+3 7,i7 ,! category ( c>e involves 
a l[ level ( complexity & l[ cl9ical    
risk4  7,,ii7 ,! category ( c>e requires
 a suppli] t is c]tifi$ or lic5s$ )9 a  
limit$ scope ( practice to ensure       
appropriate provision ( or?otic c>e4 ,! 
suppli]'s education & tra9+ %all ensure 
t basic cl9ical k & te*nical exp]tise is
 available to confirm successful fit &  
device compliance ) ! prescription4  7v7
 ,(f-!-%elf ,! category ( or?otic c>e   
describ$ 9 ?is clause is describ$ 9     
section #ahdg7;a77#b77;,c74 ,! suppli]  
qualification designation = ! category  
%all reflect t no =mal cr$5tial+1       
cl9ical education1 or te*nical tra9+ is 
requir$ to disp5se su* items4  7,d7 ,c>e
 bas$ on s\nd cl9ical judgm5t & te*nical
 exp]tise ,c>e describ$ 9 clauses 7i71  
7ii71 & 7iii7 ( subp>agraph 7,c7 %all be

 bas$ on s\nd cl9ical judgm5t & te*nical
 exp]tise bas$ on ! suppli]'s education 
& cl9ical tra9+1 9 ord] to all[ !       
practition] to det]m9e-- 7i7 ) respect  
to c>e describ$ 9 clause 7i7 or 7ii7 (  
subp>agraph 7,c71 ! device p>amet]s &   
design1 fabrication process1 &          
functional purpose specific to ! ne$s ( 
! pati5t to maximize optimal cl9ical    
outcomes2 &  7ii7 ) respect to c>e      
describ$ 9 clause 7iii7 ( su*           
subp>agraph1 ! appropriate device       
relative to ! diagnosis & specific to ! 
ne$s ( ! pati5t to maximize optimal     
cl9ical outcomes4  4  #e4 ,consultation 
,9 implem5t+ ! provisions (1 & am5dm5ts 
made by1 ?is ,act1 ! ,secret>y ( ,heal? 
& ,human ,s]vices %all consult )        
appropriate exp]ts 9 or?otics &         
pro/hetics1 includ+ suppli]s t furni%   
items )9 ! categories ( or?otic &       
pro/hetic c>e describ$ 9 p>agraph       
7#e77;,c7 ( section #ahcd7;h7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7h771 z add$ by section #d4  #f4  

,reports  7a7 ,report on en=c+ new      
lic5s+ & accr$itation requirem5ts ,n    
lat] ?an #ah mon?s aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices %all submit to 
,congress a report on ! /eps tak5 by !  
,dep>tm5t ( ,heal? & ,human ,s]vices to 
ensure t ! ,/ate lic5sure & accr$itation
 requirem5ts "u section                 
#ahcd7;h77#a77;,f7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciem7h77#a77;,f771 z am5d$ by section 
#c1 are en=c$4 ,su* report %all include 
a det]m9ation ( ! ext5t to :i* paym5ts =
 or?otics & pro/hetics "u ! ,m$ic>e     
program "u title ,,xviii ( su* ,act are 
made only to ^? suppli]s t meet !       
relevant accr$itation & lic5sure        
requirem5ts "u su* section & a          
det]m9ation ( :e!r additional /eps are  
ne$$4  7b7 ,report on fraud & abuse ,n  
lat] ?an #cj mon?s aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices %all submit to 
,congress a report on ! effect ( !      

requirem5ts "u subsection               
7a77#bj77;,b77ii7 ( section #ahcd ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#aciem71 z add$ by section #b1 &        
subsection 7h77#a77;,f7 ( su* section1 z
 am5d$ by section #c1 on ! occurr5ce (  
fraud & abuse "u ! ,m$ic>e program "u   
title ,,xviii ( su* ,act1 ) respect to  
or?otics & pro/hetics = :i* paym5t is   
made "u su* program4  #g4 ,r$uction 9   
m$ic>e sp5d+  7a7 ,projection (         
cumulative effect on sp5d+ ,n lat] ?an  
,decemb] #ca1 #bjad1 ! ,secret>y (      
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y71 act+ ?r\gh !  
,*ief ,actu>y ( ! ,c5t]s = ,m$ic>e      
,m$icaid ,s]vices 79 ?is section ref]r$ 
to z ! ,*ief ,actu>y71 %all submit to   
,congress1 & h publi%$ 9 ! ,f$]al       
,regi/]1 a projection ( ! effect on     
cumulative ,f$]al sp5d+ "u "p ,b ( title
 ,,xviii ( ! ,social ,security ,act = ! 
p]iod ( ye>s #bjad ?r\gh #bjah z a      
result ( ! implem5tation ( ! provisions 
(1 & am5dm5ts made by1 ?is ,act4  7b7   

,/r5g!n+ /&>ds applicable if sav+s n    
a*iev$  7#a7 ,9 g5]al ,subject to       
p>agraph 7#b71 if ! ,*ief ,actu>y       
projects "u subsection 7a7 t !          
implem5tation ( ! provisions (1 &       
am5dm5ts made by1 ?is ,act w n result 9 
a cumulative r$uction 9 sp5d+ "u su* "p 
( at lea/ #bej1jjj1jjj = ! p]iod ( ye>s 
#bjad ?r\gh #bjah 7us+ a #bjac basel9e71
 ! ,secret>y %all1 9 accordance ) !     
,*ief ,actu>y's projection1 issue an    
int]im f9al regulation 7to take effect =
 #bjae & subsequ5t ye>s7 ) a p]iod =    
public comm5t on su* regulation aft] !  
date ( publication to /r5g!n ! lic5sure1
 accr$itation1 & quality /&>ds          
applicable to suppli]s ( or?otics &     
pro/hetics "u title ,,xviii ( ! ,social 
,security ,act1 includ+ su* /&>ds       
describ$ 9 subsections 7a77#bj7 &       
7h77#a77;,f7 ( section #ahcd ( su* ,act 
7#db ,u4,s4,c4 #aciem71 z am5d$ by ?is  
,act1 9 ord] to produce su* cumulative  
r$uction by ,decemb] #ca1 #bjah4  7#b7  
,exception ,! int]im f9al regulation    

issu$ "u p>agraph 7#a7 %all n apply to a
 qualifi$ physical !rapi/ or qualifi$   
occupational !rapi/ 7z describ$ 9       
section #ahcd7;h77#a77;,f77iii7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7h77#a77;,f77iii7774  #h4 ,no     
effect on paym5t basis = or?otics &     
pro/hetics or competitive bidd+ programs
 ,no?+ 9 ! provisions (1 or am5dm5ts    
made by1 ?is ,act %all h any effect on--
 7#a7 ! det]m9ation ( ! paym5t basis =  
or?otics & pro/hetics "u section        
#ahcd7;h7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciem7h772 or  7#b7 !   
implem5tation ( competitive acquisition 
programs "u section #ahdg ( su* ,act    
7#db ,u4,s4,c4 #aciew-#c71 includ+ su*  
implem5tation ) respect to (f-!-%elf    
or?otics describ$ 9 subsection          
7a77#b77;,c7 ( t section1 t are includ$ 
9 a competitive acquisition program 9 a 
competitive acquisition area "u t       
section4