,i  #aad? ,,congress  #b;d ,session  ,h4
 ,r4 #ebaj  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #ab1 #bjaf ,mr4  
,tom ,price ( ,georgia 7= himself1 ,mr4 
,loebsack1 ,mrs4 ,mc,morris ,rodg]s1    
,mr4 ,wel*1 ,mr4 ,coll9s ( ,new ,york1  
,mr4 ,cram]1 ,mr4 ,flores1 ,mr4 ,h>p]1  
,mr4 ,luetkemey]1 ,mr4 ,roe ( ,t5nessee1
 ,mr4 ,?ompson ( ,p5nsylvania1 ,mr4     
,tipton1 ,ms4 ,duckwor?1 ,mr4 ,duncan ( 
,t5nessee1 ,mr4 ,joyce1 ,mr4 ,z9ke1 ,mr4
 ,kelly ( ,p5nsylvania1 ,mr4 ,blum1     
,mrs4 ,ellm]s ( ,nor? ,c>ol9a1 ,mr4     
,gohm]t1 ,mr4 ,long1 ,mr4 ,h>ris1 ,mr4  
,r5acci1 ,mr4 ,tib]i1 ,mr4 ,pet]son1    
,mr4 ,murphy ( ,p5nsylvania1 ,mrs4      
,noem1 ,mr4 ,gibbs1 ,mr4 ,au/9 ,scott ( 
,georgia1 ,mr4 ,gu?rie1 ,mr4            
,des,jarlais1 ,ms4 ,j5k9s ( ,kansas1    
,mr4 ,david ,scott ( ,georgia1 ,mrs4    
,black1 ,mrs4 ,blackburn1 ,mr4 ,smi? (  
,miss\ri1 ,mr4 ,mull91 ,mr4 ,pompeo1    
,mr4 ,byrne1 ,mrs4 ,wagn]1 & ,mr4       
,b\/any7 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 improve access  
to durable m$ical equipm5t = ,m$ic>e    
b5efici>ies "u ! ,m$ic>e program1 & =   
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,pati5t ,access to     
,durable ,m$ical ,equipm5t ,act ( #bjaf 
or ! ,,padme ,act4  #b4 ,ext5sion ( !   
transition to new paym5t rates = durable
 m$ical equipm5t "u ! m$ic>e program ,! 
,secret>y ( ,heal? & ,human ,s]vices    
%all ext5d ! transition p]iod describ$ 9
 clause 7i7 ( section #dad4baj7;g77#i7 (
 title #db1 ,code ( ,f$]al ,regulations1
 f ,june #cj1 #bjaf1 to ,septemb] #cj1  
#bjag 7) ! full implem5tation describ$ 9
 clause 7ii7 ( su* section apply+ to    
items & s]vices furni%$ ) dates ( s]vice
 on or aft] ,octob] #a1 #bjag74  #c4    
,bid ceil+ = competitive acquisition =  
durable m$ical equipm5t "u ! m$ic>e     

program ,section #ahdg7;b77#e7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#c7;b77#e77 is am5d$-- 7#a7 9    
subp>agraph 7,a7--  7,a7 by ins]t+ 1    
subject to subp>agraph 7,e71 aft]       
subsection 7a77#b72 &  7,b7 by ins]t+ 1 
subject to subp>agraph 7,e71 aft] ,bas$ 
on su* bids2 &  7#b7 by add+ at ! end ! 
foll[+ new subp>agraph3  7,e7 ,bid ceil+
 = durable m$ical equipm5t  7i7 ,9 g5]al
 ,! ceil+ = a bid submitt$ = applicable 
cov]$ items may n be less ?an ! fee     
s*$ule am\nt t w\ld o!rwise be det]m9$ =
 su* items "u section #ahcd7;a71 section
 #ahcd7;h71 or section #ahdb7s77#a7 on  
,janu>y #a1 #bjae1 updat$ by ! cov]$    
item update = su* items "u section      
#ahcd7;a77#ad77,l71 section #ahcd7;h71  
or section #ahdb7s77#a71 respectively1 z
 appropriate = ! ye> ) respect to :i* ! 
bid ceil+ is e/abli%$ = su* applicable  
cov]$ item4  7ii7 ,application to new   
cov]$ items ,! ,secret>y %all e/abli% a 
process = purposes ( apply+ clause 7i7 )
 respect to applicable cov]$ items = :i*

 no fee s*$ule am\nt w\ld o!rwise be    
paid "u section #ahcd7;a71 section      
#ahcd7;h71 or section #ahdb7s71 z       
appropriate1 on ,janu>y #a1 #bjae4      
7iii7 ,applicable cov]$ items def9$ ,=  
purposes ( ?is subp>agraph1 ! t]m       
applicable cov]$ items means            
competitively pric$ items & s]vices     
describ$ 9 subsection 7a77#b7 t are     
furni%$ ) respect to r\nds ( competition
 t beg9 on or aft] ,janu>y #a1 #bjag4  4
  #d4 ,requirem5ts 9 det]m9+ adju/m5ts  
us+ in=mation f competitive bidd+       
programs ,section #ahcd7;a77#a77;,g7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciem7a77#a77;,g77 is am5d$ by add+ at 
! end ! foll[+ new s5t5ce3 ,9 ! case (  
items & s]vices furni%$ on or aft]      
,janu>y #a1 #bjai1 9 mak+ any adju/m5ts 
"u clause 7ii7 or 7iii7 ( subp>agraph   
7,f71 ! ,secret>y %all--  7i7 solicit & 
take into acc\nt /akehold] input2 &     
7ii7 take into acc\nt ! highe/ am\nt bid
 by a w9n+ suppli] 9 a competitive      
acquisition area & a comp>ison ( ea* ( !

 foll[+ ) respect non-competitive       
acquisition areas & competitive         
acquisition areas3  7,i7 ,! av]age      
travel di/ance & co/ associat$ ) furni%+
 items & s]vices 9 ! area4  7,,ii7 ,any 
b>ri]s to access = items & s]vices 9 !  
area4  7,,iii7 ,! av]age deliv]y "t 9   
furni%+ items & s]vices 9 ! area4       
7,,iv7 ,! av]age volume ( items &       
s]vices furni%$ by suppli]s 9 ! area4   
7,v7 ,! numb] ( suppli]s 9 ! area4  4   
#e4 ,mon?ly report on ! results ( !     
monitor+ ( access ( m$ic>e b5efici>ies  
to durable m$ical equipm5t & ( heal?    
outcomes ,n lat] ?an ! fir/ ( ea* mon?  
7beg9n+ ) ,may #a1 #bjaf1 & end+ )      
,septemb] #a1 #bjag71 ! ,secret>y (     
,heal? & ,human ,s]vices %all publi% on 
! ,int]net website ( ! ,c5t]s = ,m$ic>e 
,m$icaid ,s]vices ! results ( ! monitor+
 ( access ( ,m$ic>e b5efici>ies to      
durable m$ical equipm5t & ( heal?       
outcomes1 z describ$ on page #ffbbh 9 ! 
f9al rule publi%$ by ! ,c5t] = ,m$ic>e  
,m$icaid ,s]vices on ,novemb] #f1 #bjad1

 & entitl$ ,m$ic>e ,program2 ,end-,/age 
,r5al ,disease ,prospective ,paym5t     
,sy/em1 ,quality ,inc5tive ,program1 &  
,durable ,m$ical ,equipm5t1 ,pro/hetics1
 ,or?otics1 & ,supplies 7#gi ,f$4 ,reg4 
#ffabj-ffbfe74  #f4 ,requir+ r$uction 9 
,f$]al exp5ditures to fully (fset       
increas$ exp5ditures f ?is ,act ,x is ! 
s5se ( ,congress t ?is ,act %\ld n be   
enact$ unless ! increase 9 ,f$]al       
exp5ditures "u ?is ,act is fully (fset  
?r\gh a decrease 9 o!r ,f$]al           
exp5ditures4