#aad? ,,congress  #b;d ,session  ,s4    
#bgcf  ,,an ,,act  ,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$ical ,equipm5t ,act ( #bjaf4
  #b4 ,ext5sion ( ! transition to new   
paym5t rates = durable m$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$]al ,regulations1 f ,june    
#cj1 #bjaf1 to ,june #cj1 #bjag 7) !    
full implem5tation describ$ 9 clause    
7ii7 ( su* section apply+ to items &    
s]vices furni%$ ) dates ( s]vice on or  
aft] ,july #a1 #bjag74  #c4 ,floor on   
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 ,floor on 
bid ceil+ = durable m$ical equipm5t  7i7
 ,9 g5]al ,! ceil+ = a bid submitt$ =   
applicable cov]$ items may n be less ?an
 ! fee s*$ule am\nt t w\ld o!rwise be   
det]m9$ "u section #ahcd7;a71 section   
#ahcd7;h71 or section #ahdb7s7 = su*    
items furni%$ on ,july #a1 #bjaf        
7det]m9$ z if section #b ( ! ,pati5t    
,access to ,durable ,m$ical ,equipm5t   
,act ( #bjaf _h n be5 enact$74  7ii7    
,applicable cov]$ 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  7a7 ,9 g5]al ,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 8,9 ! 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 "u subsection 
7h77#a77;,h77ii71 or "u section         
#ahdb7s77#c77;,b71 ! ,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 to 
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   
7b7 ,con=m+ am5dm5ts  7#a7 ,section     

#ahcd7;h77#a77;,h77ii7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciem7h77#a77;,h77ii77 is am5d$ by     
/rik+ ! ,secret>y & ins]t+ subject to   
subsection 7a77#a77;,g71 ! ,secret>y4   
7#b7 ,section #ahdb7s77#c77;,b7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7s77#c77;,b77 is am5d$ by /rik+ ! 
,secret>y & ins]t+ subject to section   
#ahcd7;a77#a77;,g71 ! ,secret>y4  #e4   
,reports on ! results ( ! monitor+ (    
access ( ,m$ic>e b5efici>ies to durable 
m$ical equipm5t & ( heal? outcomes ,n   
lat] ?an ,octob] #a1 #bjaf1 ,janu>y #a1 
#bjag1 ,april #a1 #bjag1 & ,july #a1    
#bjag1 ! ,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$4 ,reg4 #ffabj-ffbfe74
  #f4 ,revision ( effective date (      
provision limit+ ,f$]al ,m$icaid        
reimbursem5t to ,/ates = durable m$ical 
equipm5t 7,,dme7 to ,m$ic>e paym5t rates
  7a7 ,9 g5]al ,section #aijc7;i77#bg7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acif;b7i77#bg77 is am5d$ by /rik+     
,janu>y #a1 #bjai & ins]t+ ,octob] #a1  
#bjah4  7b7 ,effective date ,! am5dm5t  
made by subsection 7a7 %all take effect 
z if includ$ 9 ! enactm5t ( section #ejc
 ( division ,o ( ,public ,law #aad-aac4 
,pass$ ! ,s5ate ,june #ba1              
#bjaf4,secret>y