,,ii  #aadth ,,congress  #b;d ,session  
,s4 #caie  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #ac1     
#bjaf ,mr4 ,cassidy 7for himself and    
,mr4 ,grassley7 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 preserve      
,medicare beneficiary access to         
ventilators1 and for other purposes4    
#a4 ,short title  ,this ,act may be     
cited as the ,beneficiary ,respiratory  
,equipment ,access and ,transparency to 
,home ,ventilator ,care ,act of #bjaf or
 the ,,breath ,act of #bjaf4  #b4       
,promoting evidence-based care for      
certain ventilators and other items of  
durable medical equipment ,section      
#ahcd7;a7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #acie7m77 is amended by  
adding at the end the following new     
subsection3  7t7 ,appropriate use       
criteria for certain ventilators ,not   
later than ,january #a1 #bjag1 and in   

consultation with medical experts1 the  
,secretary shall establish policies and 
standards for determining the           
appropriate use of ventilators as       
described in subsection 7a77#c77;,a74  4
  #c4 ,reimbursement for home mechanical
 ventilators  7a7 ,in general ,section  
#ahcd7;a77#c7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #aciem7a77#c77 is   
amended-- 7#a7 in subparagraph 7,b7--   
7,a7 in clause 7iii71 by striking and at
 the end2  7,b7 in clause 7iv7--  7i7 by
 inserting 1 except as provided in      
clause 7v71 after subsequent year2 and  
7ii7 by striking the period at the end  
and inserting 2 and2 and  7,c7 by adding
 at the end the following new clause3   
7v7 in #bjag and each subsequent year1  
in the case of a ventilator described in
 subparagraph 7,a71 the payment rate    
determined for the ventilator under     
subparagraph 7,d7 for that year4  2 and 
7#b7 by adding at the end the following 
new subparagraph3  7,d7 ,payment rates  
for ventilators ,for purposes of        

subparagraph 7,b77v71 payment for a     
ventilator described in subparagraph    
7,a7 shall be made as follows3  7i7     
#bjag payment rate ,for #bjag1 at a rate
 equal to #abj percent of the rate      
determined under subparagraph 7,b7 for  
#bjaf1 increased by the covered item    
update for the year4  7ii7 #bjah payment
 rate ,for #bjah1 at the rate determined
 under this subparagraph for #bjag--    
7,i7 increased by the covered item      
update for the year2  7,,ii7 increased  
or decreased1 expressed as a percentage1
 by the difference between-- 7aa7 the   
absolute percentage difference in the   
number of beneficiaries for whom the    
program made payment for the rental of  
such item or device during #bjag and the
 number of beneficiaries for whom the   
program made payment for the rental of  
the item or device during #bjae2 and    
7bb7 #bj percent2 and  7,,iii7 increased
 or decreased by the percentage change  
in the total number of ,medicare        
beneficiaries in #bjae as compared to   

#bjag4  7iii7 #bjai and subsequent years
 payment rate ,for #bjai and subsequent 
years1 at the rate determined under this
 subparagraph for the previous year     
increased by the covered item update for
 the year4  4  7b7 ,application ,the    
,secretary shall implement the          
provisions of1 and amendments made by1  
this section in a budget neutral manner 
and any such budget neutrality          
adjustment shall be limited to payments 
for a ventilator described in section   
#ahcd7;a77#c77;,a7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#aciem7a77#c77;,a774