,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #ajah  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,febru>y #bj1 #bjae   
,mrs4 ,ellm]s ( ,nor? ,c>ol9a 7= h]self1
 ,mr4 ,butt]field1 & ,mrs4 ,blackburn7  
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 provide       
cov]age ( c]ta9 disposable m$ical       
te*nologies "u ! ,m$ic>e program1 & =   
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,pati5t ,access to     
,disposable ,m$ical ,te*nology ,act (   
#bjae4  #b4 ,cov]age ( c]ta9 disposable 
m$ical te*nologies "u ! ,m$ic>e program 
7a7 ,cov]age ,section #ahfa ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #aciex7 is
 am5d$ by add+ at ! end ! foll[+ new    
subsection3  7iii7 ,sub/itute disposable

 m$ical te*nology ,! t]m sub/itute      
disposable m$ical te*nology means m$ical
 equipm5t t-- 7#a7 is prim>ily &        
cu/om>ily us$ to s]ve a m$ical purpose2 
7#b7 w\ld o!rwise be cov]$ z durable    
m$ical equipm5t "u ?is title b = ! fact 
t su* equipm5t is n durable 7z def9$ by 
! ,secret>y = purposes ( cov]age (      
durable m$ical equipm5t "u ?is title72 &
  7#c7 ! ,secret>y det]m9es sub/itutes =
 durable m$ical equipm5t4  4  7b7       
,paym5t provisions ,section #ahcd7;a7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciem7a77 is am5d$ by add+ at ! end !  
foll[+ new p>agraph3  7#bc7 ,special    
paym5t rule = sub/itute disposable      
m$ical te*nologies ,not)/&+ ! prec$+    
provisions ( ?is subsection1 ! ,secret>y
 %all det]m9e ! paym5t am\nt "u ?is     
subsection = a sub/itute disposable     
m$ical te*nology 7z def9$ 9 section     
#ahfa7;iii771 & = any s]vices & supplies
 us$ 9 conjunction ) su* te*nology1 9   
accordance ) ! foll[+3  7,a7 ,s+le      
paym5t am\nt ,! ,secret>y %all det]m9e a

 s+le paym5t am\nt t %all be paid = a   
sub/itute disposable m$ical te*nology & 
= any s]vices & supplies us$ 9          
conjunction ) su* te*nology4 ,a paym5t =
 su* a te*nology & = any su* s]vices &  
supplies t is made 9 ! am\nt ( su* s+le 
paym5t am\nt %all con/itute full paym5t 
"u ?is title = su* te*nology & su*      
s]vices & supplies4  7,b7 ,calculation (
 paym5t am\nt ,! s+le paym5t am\nt      
describ$ 9 subp>agraph 7,a7 = a         
sub/itute disposable m$ical te*nology & 
= any s]vices & supplies us$ 9          
conjunction ) su* te*nology %all be     
calculat$ by--  7i7 calculat+ ! sum ( ! 
am\nts ( paym5t t o!rwise w\ld be made  
"u ?is section =-- 7,i7 ! item ( durable
 m$ical equipm5t = :i* ! ,secret>y      
det]m9es1 pursuant to section           
#ahfa7;iii77#c71 t su* sub/itute        
disposable m$ical te*nology sub/itutes2 
&  7,,ii7 all s]vices & supplies us$ 9  
conjunction ) su* item ( durable m$ical 
equipm5t2  7ii7 calculat+ ! am\nt t is  
#ie p]c5t ( ! sum calculat$ "u clause   

7i72 &  7iii7 calculat+ ! s+le paym5t   
am\nt = ! sub/itute disposable m$ical   
te*nology & = any s]vices & supplies us$
 9 conjunction ) su* te*nology su* t !  
sum ( ! paym5ts "u ?is subsection =--   
7,i7 all sub/itute disposable m$ical    
te*nologies t ! ,secret>y det]m9es1     
pursuant to section #ahfa7;iii77#c71 w  
be necess>y to provide a sub/itute = !  
item ( durable m$ical equipm5t describ$ 
9 clause 7i77,i72 &  7,,ii7 any s]vices 
& supplies us$ 9 conjunction ) su*      
te*nologies2  is equal to ! am\nt       
calculat$ "u clause 7ii74  7,c7         
,lump-sum paym5t ,! s+le paym5t am\nt   
describ$ 9 subp>agraph 7,a7 = a         
sub/itute disposable m$ical te*nology & 
= any s]vices & supplies us$ 9          
conjunction ) su* te*nology %all be made
 9 a lump-sum am\nt4  4  7c7            
,nonapplication ( competitive           
acquisition ,section #ahdg7;a77#g77;,b7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciew-#c7;a77#g77;,b77 is    
am5d$-- 7#a7 9 clause 7i71 by /rik+ & at

 ! end2  7#b7 9 clause 7ii71 by /rik+ ! 
p]iod at ! end & ins]t+ 2 &2 &  7#c7 by 
add+ at ! end ! foll[+ new clause3      
7iii7 t are sub/itute disposable m$ical 
te*nologies 7z def9$ 9 section          
#ahfa7n77#b77;,b774  4  7d7 ,effective  
date ,! am5dm5ts made by ?is section    
%all apply ) respect to items & s]vices 
furni%$ on or aft] ! date t is "o ye>   
aft] ! date ( ! enactm5t ( ?is section4