,,ii #aadth ,,congress #ast ,session ,s4 #abec ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #g1 #bjae,mr4 ,burr 7for himself and ,mr4 ,bennet7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to provide coverage of certain disposable medical technologies under the ,medicare program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,patient ,access to ,disposable ,medical ,technology ,act of #bjae4 #b4 ,coverage of certain disposable medical technologies under the ,medicare program 7a7 ,coverage ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended-- 7#a7 in subsection 7n7-- 7,a7 by inserting substitute disposable medical technologies 7as defined in subsection 7iii77 and services and supplies used in conjunction with such technologies1 after hospital beds12 and 7,b7 by inserting 7unless such equipment is a substitute disposable medical technology or a service or supply used in conjunction with such a technology7 after rental basis2 and 7#b7 by adding at the end the following new subsection3 7iii7 ,substitute disposable medical technology ,the term substitute disposable medical technology means medical equipment that-- 7#a7 is primarily and customarily used to serve a medical purpose2 7#b7 would otherwise be covered as durable medical equipment under this title but for the fact that such equipment is not durable 7as defined by the ,secretary for purposes of coverage of durable medical equipment under this title72 and 7#c7 the ,secretary determines substitutes for durable medical equipment4 ,in making the determination under paragraph 7#c71 the ,secretary shall consult with medical specialty societies1 medical device manufacturers1 patient groups1 and other stakeholders as part of the annual rulemaking process for durable medical equipment under this title4 4 7b7 ,payment provisions ,section #ahcd7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7a77 is amended by adding at the end the following new paragraph3 7#bc7 ,special payment rule for substitute disposable medical technologies ,notwithstanding the preceding provisions of this subsection1 the ,secretary shall determine the payment amount under this subsection for a substitute disposable medical technology 7as defined in section #ahfa7;iii771 and for any related supplies and service fees incurred in conjunction with the use and maintenance of such technology1 in accordance with the following3 7,a7 ,single payment amount ,the ,secretary shall determine a single payment amount that shall be paid for a substitute disposable medical technology and for any related supplies and service fees incurred in conjunction with the use and maintenance of such technology4 ,a payment for such a technology and for any such related supplies and service fees made in the amount of such single payment amount shall constitute full payment under this title for such technology and such related supplies and service fees4 7,b7 ,calculation of payment amount ,the single payment amount described in subparagraph 7,a7 for a substitute disposable medical technology and for any related supplies and service fees incurred in conjunction with the use and maintenance of such technology shall be calculated by-- 7i7 calculating the sum of the amounts of payment that otherwise would be made under this section for-- 7,i7 the item of durable medical equipment for which the ,secretary determines1 pursuant to section #ahfa7;iii77#c71 that such substitute disposable medical technology substitutes2 and 7,,ii7 all related supplies and service fees incurred in conjunction with the use and maintenance of such item of durable medical equipment2 7ii7 calculating the amount that is #ie percent of the sum calculated under clause 7i72 and 7iii7 calculating the single payment amount for the substitute disposable medical technology and for any related supplies and service fees incurred in conjunction with the use and maintenance of such technology such that the sum of the payments under this subsection for-- 7,i7 all substitute disposable medical technologies that the ,secretary determines1 pursuant to section #ahfa7;iii77#c71 will be necessary to provide a substitute for the item of durable medical equipment described in clause 7i77,i72 and 7,,ii7 any related supplies and service fees incurred in conjunction with the use and maintenance of such technologies1 and is equal to the amount calculated under clause 7ii74 ,in making such calculation1 the ,secretary shall consult with medical specialty societies1 medical device manufacturers1 patient groups1 and other stakeholders to ensure that an appropriate comparison is made that captures use of the various technologies 7including related supplies1 if any7 over an average course of therapy for a typical patient4 7,c7 ,lump-sum payment ,the single payment amount described in subparagraph 7,a7 for a substitute disposable medical technology and for any related supplies and service fees incurred in conjunction with the use and maintenance of such technology shall be made in a lump-sum amount4 7,d7 ,payment for physicians' and hospital outpatient department services ,nothing in this paragraph should be construed as limiting or changing payment for items or services for which payment is made under section #ahdh or section #ahcc7t74 4 7c7 ,conforming amendment ,section #ahdg7;a77#g77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#c7;a77#g77;,b77 is amended-- 7#a7 in clause 7i71 by striking and at the end2 7#b7 in clause 7ii71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new clause3 7iii7 that are substitute disposable medical technologies 7as defined in section #ahfa7;iii774 4 7d7 ,effective date ,the provisions of1 and amendments made by1 this section shall apply with respect to items and services furnished on or after ,january #a1 #bjaf4 7e7 ,rule of construction2 implementation 7#a7 ,rule of construction ,nothing in this section or the amendments made by this section shall be construed as-- 7,a7 affecting the ability of a physician 7or any other prescribing practitioner7 to exercise their judgment in prescribing or ordering for a ,medicare beneficiary appropriate durable medical equipment or other medical device or technology for the treatment of an illness1 injury1 or condition of the ,medicare beneficiary2 or 7,b7 affecting the ability of the ,medicare beneficiary to access appropriate durable medical equipment or other appropriate medical device or technology for such treatment4 7#b7 ,implementation ,the ,secretary shall implement the provisions of1 and amendments made by1 this section in a manner such that the methodologies for determining coverage of an item of durable medical equipment 7as defined in section #ahfa7n7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7n777 7other than such an item that is a substitute disposable medical technology 7as defined in section #ahfa7;iii777 and the payment amount for the item of durable medical equipment 7other than such an item that is a substitute disposable medical technology 7as so defined77 under section #ahcd or #ahdg of such ,act 7#db ,u4,s4,c4 #aciem1 #aciew-#c71 as the case may be1 is not affected by the coverage of and payment amount for a substitute disposable medical technology under sections #ahfa7;iii7 and #ahcd7;a77#bc7 of such ,act1 respectively1 as added by subsections 7a7 and 7b71 respectively4