,,ii #aadth ,,congress #ast ,session ,s4 #bcab ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,november #ai1 #bjae ,mr4 ,thune 7for himself1 ,ms4 ,heitkamp1 ,mr4 ,roberts1 ,mr4 ,king1 ,mr4 ,crapo1 ,ms4 ,collins1 and ,mrs4 ,capito7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend titles ,,xviii and ,,xix of the ,social ,security ,act to make improvements to payments for durable medical equipment under the ,medicare and ,medicaid programs4 #a4 ,short title ,this ,act may be cited as the ,,dme ,access and ,stabilization ,act of #bjae4 #b4 ,revision of payments for durable medical equipment under the ,medicare program 7a7 ,transition to implementation of fee schedule payment adjustments using information from competitive bidding programs ,section #ahcd7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7a77#a77 is amended by adding at the end the following new subparagraph3 7,j7 ,transition to implementation of payment adjustments using information from competitive bidding programs 7i7 ,in general ,in implementing subparagraph 7,f7 and paragraphs 7#a7 and 7#b7 of section #dad4baj7;g7 of title #db1 ,code of ,federal ,regulations with respect to items and services furnished on or after ,january #a1 #bjaf1 and before ,january #a1 #bjai1 the fee schedule amount that would otherwise be determined for each area under this section shall be adjusted to the lesser of-- 7,i7 the applicable percent of the regional price determined under clause 7i7 of such paragraph 7#a7 for the region in which such area is located2 and 7,,ii7 the fee schedule amount that would otherwise be determined for such area under this section on ,january #a1 #bjae1 updated by the covered item update described in paragraph 7#ad77,l7 for the year in which the items and services to which such fee schedule applies are furnished4 7ii7 ,applicable percent ,for purposes of clause 7i77,i71 the term applicable percent means-- 7,i7 for an area defined as a rural area for purposes of such section #dad4baj7;g7 or an area in a frontier ,state 7as defined in section #ahhf7;d77#c77;,e77iii77,,ii771 #acj percent2 and 7,,ii7 for any other area1 #abj percent4 7iii7 ,phase-in ,the adjustment described in clause 7i7 shall be implemented over a two-year period and in a manner that phases in such adjustment in equal increments in each year of such two-year period1 with such adjustment being fully implemented with respect to items and services furnished in #bjag4 4 7b7 ,bid ceiling for competitive acquisition for durable medical equipment under the ,medicare program ,section #ahdg7;b77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#c7;b77#e77 is amended-- 7#a7 in subparagraph 7,a7-- 7,a7 by inserting 1 subject to subparagraph 7,e71 after subsection 7a77#b72 and 7,b7 by inserting 1 subject to subparagraph 7,e71 after ,based on such bids2 and 7#b7 by adding at the end the following new subparagraph3 7,e7 ,bid ceiling for durable medical equipment ,in the case of covered items 7as defined in section #ahcd7;a77#ac77 for which payment would otherwise be made under section #ahcd7;a7 that are furnished with respect to competitive bid contracts that begin on or after ,january #a1 #bjai1 the ,secretary may not establish a ceiling on bids submitted under this section for such items that is less than the amount that would otherwise be paid for such items under section #ahcd 7without the application of subsection 7a77#a77;,f7 of such section7 on ,january #a1 #bjae1 updated by the covered item update described in subsection 7a77#ad77,l7 of such section for the year in which such covered item is furnished4 4 7c7 ,requirements in determining adjustments using information from competitive bidding programs ,section #ahcd7;a77#a77;,g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7a77#a77;,g77 is amended by adding at the end the following new sentence3 ,in the case of items and services furnished on or after ,january #a1 #bjai1 in making any adjustments under clause 7ii7 or 7iii7 of subparagraph 7,f71 the ,secretary shall solicit and receive stakeholder input and shall also take into account the average travel distance and cost associated with furnishing items and services in a competitive acquisition area1 the average volume of items and services furnished by providers in such an area1 the clearing price of items and services1 and the number of providers in competitive acquisition areas compared to the number of providers in non-competitive acquisition areas44 #c4 ,limiting ,federal ,medicaid reimbursement to ,states for durable medical equipment 7,,dme7 to ,medicare payment rates 7a7 ,medicaid reimbursement 7#a7 ,in general ,section #aijc7;i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7i77 is amended-- 7,a7 in paragraph 7#be71 by striking or at the end2 7,b7 in paragraph 7#bf71 by striking the period at the end and inserting 2 or2 and 7,c7 by inserting after paragraph 7#bf7 the following new paragraph3 7#bg7 with respect to any amounts expended by the ,state on the basis of a fee schedule for items described in section #ahfa7n71 as determined in the aggregate with respect to each class of such items as defined by the ,secretary1 in excess of the aggregate amount1 if any1 that would be paid for such items within such class on a fee-for-service basis under the program under part ,b of title ,,xviii1 including1 as applicable1 under a competitive acquisition program under section #ahdg in an area of the ,state4 4 7#b7 ,effective date ,the amendments made by this subsection shall be effective with respect to payments for items furnished on or after ,january #a1 #bjbj4 7b7 ,medicare ,beneficiary ,ombudsman ,section #ahjh7;c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;b7c77 is amended by adding at the end the following new paragraph3 7#d7 ,monitoring ,,dme reimbursement under ,medicaid ,the ,medicare ,beneficiary ,ombudsman shall evaluate the impact of the competitive acquisition program under section #ahdg1 including as applied under section #aijc7;i77#bg71 on beneficiary health status and health outcomes4 4