,i  #aad? ,,congress  #b;d ,session  ,h4
 ,r4 #fjab  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #ac1        
#bjaf,mr4 ,buc%on 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 pres]ve ,m$ic>e b5efici>y access to 
v5tilators1 & = o!r purposes4  #a4 ,%ort
 title ,?is ,act may be cit$ z !        
,b5efici>y ,respiratory ,equipm5t       
,access & ,transp>5cy to ,home          
,v5tilator ,c>e ,act ( #bjaf or !       
,,brea? ,act ( #bjaf4  #b4 ,promot+     
evid5ce-bas$ c>e = c]ta9 v5tilators &   
o!r items ( durable m$ical equipm5t     
,section #ahcd7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acie7m77 is am5d$ 
by add+ at ! end ! foll[+ new           
subsection3  7t7 ,appropriate use       

crit]ia = c]ta9 v5tilators ,n lat] ?an  
,janu>y #a1 #bjag1 & 9 consultation )   
m$ical exp]ts1 ! ,secret>y %all e/abli% 
policies & /&>ds = det]m9+ ! appropriate
 use ( v5tilators z describ$ 9          
subsection 7a77#c77;,a74  4  #c4        
,reimbursem5t = home me*anical          
v5tilators  7a7 ,9 g5]al ,section       
#ahcd7;a77#c7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciem7a77#c77 is       
am5d$--  7#a7 9 subp>agraph 7,b7-- 7,a7 
9 clause 7iii71 by /rik+ & at ! end2    
7,b7 9 clause 7iv7-- 7i7 by ins]t+ 1    
except z provid$ 9 clause 7v71 aft]     
subsequ5t ye>2 &  7ii7 by /rik+ ! p]iod 
at ! end & ins]t+ 2 &2 &  7,c7 by add+  
at ! end ! foll[+ new clause3  7v7 9    
#bjag & ea* subsequ5t ye>1 9 ! case ( a 
v5tilator describ$ 9 subp>agraph 7,a71 !
 paym5t rate det]m9$ = ! v5tilator "u   
subp>agraph 7,d7 = t ye>4  2 &  7#b7 by 
add+ at ! end ! foll[+ new subp>agraph3 
7,d7 ,paym5t rates = v5tilators ,=      
purposes ( subp>agraph 7,b77v71 paym5t =
 a v5tilator describ$ 9 subp>agraph 7,a7

 %all be made z foll[s3 7i7 #bjag paym5t
 rate ,= #bjag1 at a rate equal to #abj 
p]c5t ( ! rate det]m9$ "u subp>agraph   
7,b7 = #bjaf1 increas$ by ! cov]$ item  
update = ! ye>4  7ii7 #bjah paym5t rate 
,= #bjah1 at ! rate det]m9$ "u ?is      
subp>agraph = #bjag-- 7,i7 increas$ by !
 cov]$ item update = ! ye>2  7,,ii7     
increas$ or decreas$1 express$ z a      
p]c5tage1 by ! diff]5ce betwe5-- 7aa7 ! 
absolute p]c5tage diff]5ce 9 ! numb] (  
b5efici>ies = :om ! program made paym5t 
= ! r5tal ( su* item or device dur+     
#bjag & ! numb] ( b5efici>ies = :om !   
program made paym5t = ! r5tal ( ! item  
or device dur+ #bjae2 &  7bb7 #bj p]c5t2
 &  7,,iii7 increas$ or decreas$ by !   
p]c5tage *ange 9 ! total numb] ( ,m$ic>e
 b5efici>ies 9 #bjae z comp>$ to #bjag4 
7iii7 #bjai & subsequ5t ye>s paym5t rate
 ,= #bjai & subsequ5t ye>s1 at ! rate   
det]m9$ "u ?is subp>agraph = ! previ\s  
ye> increas$ by ! cov]$ item update = ! 
ye>4  4  7b7 ,application ,! ,secret>y  
%all implem5t ! provisions (1 & am5dm5ts

 made by1 ?is section 9 a budget neutral
 mann]4