,,ii  #aad? ,,congress  #b;d ,session   
,s4 #bgcf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #ag1 #bjaf ,mr4   
,?une 7= himself1 ,ms4 ,heitkamp1 ,mr4  
,rob]ts1 ,mr4 ,crapo1 ,mr4 ,r\nds1 ,mrs4
 ,capito1 ,mr4 ,grassley1 ,mr4 ,man*91  
,mr4 ,da9es1 ,mr4 ,b>rasso1 ,mr4        
,co*ran1 ,ms4 ,hirono1 ,mr4 ,b5net1     
,mrs4 ,ern/1 ,mr4 ,k+1 & ,mr4 ,te/]7    
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,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$ical ,equipm5t ,act ( #bjaf4
  #b4 ,ext5sion ( ! transition to new   
paym5t rates = durable m$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 ,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 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 ! ,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$4 ,reg4 
#ffabj-ffbfe74  #f4 ,revision (         
effective date ( provision limit+ ,f$]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