,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #bdcg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #ai1 #bjae ,mrs4 
,blackburn 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 "p ,b (    
title ,,xviii ( ! ,social ,security ,act
 reg>d+ high co/ durable m$ical         
equipm5t1 & = o!r purposes4  4 ,prior   
au?orization process = c]ta9 high co/   
durable m$ical equipm5t1 pro/hetics1    
or?otics1 & supplies "u ! ,m$ic>e       
program ,section #ahcd7;a77#ae7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7a77#ae77 is am5d$-- 7#a7 9 !     
p>agraph head+1 by /rik+ items& ins]t+  
items2 prior au?orization process =     
c]ta9 high co/ durable m$ical equipm5t1 
pro/hetics1 or?otics1 & supplies2 &     
7#b7 by add+ at ! end ! foll[+ new      

subp>agraph3  7,d7 ,prior au?orization  
process = c]ta9 high co/ durable m$ical 
equipm5t1 pro/hetics1 or?otics1 &       
supplies  7i7 ,9 g5]al ,n lat] ?an #a   
ye> aft] ! date ( ! enactm5t ( ?is      
subp>agraph1 ! ,secret>y %all beg9 !    
process to develop & implem5t a prior   
au?orization process = c]ta9 durable    
m$ical equipm5t1 pro/hetics1 or?otics1 &
 supplies4 ,a claim = an item ( durable 
m$ical equipm5t1 a pro/hetic1 an        
or?otic1 or a supply t has receiv$ prior
 approval ?r\gh ! prior au?orization    
process %all be exempt f subsequ5t pre- 
& po/-paym5t audits & only subject to   
audits = sy/ematic fraud & abuse4  7ii7 
,consid]ation ( factors ,! ,secret>y    
%all consid] ! foll[+ factors 9 develop+
 & implem5t+ ! prior au?orization       
process "u ?is subp>agraph3 7,i7        
,b5efici>y access to timely c>e4  7,,ii7
 ,alignm5t ) ! be/ practices ( comm]cial
 manag$ c>e plans & ,m$ic>e ,advantage  
plans "u "p ,c t h exp]tise 9 prior     
au?orization processes4  7,,iii7        

,implem5tation ( /&>d m$ical necessity  
evaluation prior au?orization reque/s = 
physician & hospital ref]ral ag5ts &    
non-physician practition]s4  7,,iv7     
,acc\nt+ = same day deliv]y expectations
 by provid+ = exp$it$ em]g5cy review =  
c]ta9 items1 includ+ oxyg54  7iii7      
,implem5tation ,! ,secret>y %all        
promulgate a regulation to c>ry out !   
prior au?orization process "u ?is       
subp>agraph4 ,! regulation %all--  7,i7 
ensure t /akehold]s p>ticipate 9 !      
developm5t ( ! process2 &  7,,ii7 place 
priority on prior au?orization ( items t
 are subject to a high numb] (          
contractor audits1 includ+ oxyg54  4