,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #dide  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,octob] #ca1 #bjai,mr4
 ,griffi? 7= himself1 ,mr4 ,wel*1 ,mr4  
,bilirakis1 ,mr4 ,soto1 & ,mr4 ,l>son ( 
,connecticut7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
exclude v5tilators f competitive        
acquisition programs "u ! ,m$ic>e       
program = #e ye>s1 & = o!r purposes4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,safegu>d+ ,m$ic>e ,access to         
,respiratory ,!rapy ,act ( #bjai4  #b4  
,exclud+ v5tilators & c]ta9 o!r         
respiratory items f competitive         
acquisition programs "u ! ,m$ic>e       
program = #e ye>s ,section              
#ahdg7;a77#b77;,a7 ( ! ,social ,security

 ,act 7#db ,u4,s4,c4                    
#aciew-#c7;a77#b77;,a77 is am5d$ by     
ins]t+ exclud+ v5tilators 7:e!r invasive
 or non9vasive7 & any o!r respiratory   
cov]$ item 7z def9$ 9 p>agraph 7#ac7 (  
section #ahcd7;a77 payable "u p>agraph  
7#c7 ( su* section & furni%$ on or aft] 
,janu>y #a1 #bjbj1 & be=e ,janu>y #a1   
#bjbe1 be=e & exclud+ drugs &           
biologicals44  #c4 ,requir+ ! e/abli%m5t
 ( updat$ national cov]age policies to  
reflect innovation 9 te*nology = home   
me*anical v5tilator devices "u ! ,m$ic>e
 program  7a7 ,9 ,g5]al ,section        
#ahfi7;f7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;ff7f77 is am5d$ by 
add+ at ! end ! foll[+ new p>agraph3    
7#i7 ,te*nical exp]t panel review &     
update ( national cov]age det]m9ations =
 home me*anical v5tilators & c]ta9 o!r  
respiratory devices  7,a7 ,9 g5]al ,n   
lat] ?an #ij days aft] ! date ( !       
enactm5t ( ?is p>agraph1 ! ,secret>y    
7?r\gh use ( a contractor or o!rwise7   
%all e/abli% a te*nical exp]t panel =   

purposes ( review+ national cov]age     
det]m9ations ) respect to cov]age "u "p 
,b = home invasive & non9vasive         
v5tilators & o!r non9vasive respiratory 
devices 7includ+ respiratory devices )  
bi-level pressure capability7 & mak+    
recomm5dations = revis+ su*             
det]m9ations4  7,b7 ,review1 assessm5t1 
& recomm5dations ,n lat] ?an #a ye> aft]
 ! date ! te*nical exp]t panel describ$ 
9 subp>agraph 7,a7 is e/abli%$ 7&       
p]iodically !reaft] z ! ,secret>y       
det]m9es appropriate71 ! te*nical exp]t 
panel %all review /akehold] input &     
cl9ical lit]ature & make recomm5dations 
to ! ,secret>y1 ) respect to national   
cov]age det]m9ations describ$ 9 su*     
p>agraph1 relat+ to--  7i7 def9+ home   
invasive v5tilators & home non9vasive   
v5tilators2  7ii7 def9+ ! t]m           
respiratory failure = purposes (        
e/abli%+ crit]ia = ! appropriate use (  
home invasive or non9vasive v5tilators2 
7iii7 e/abli%+ m$ical necessity crit]ia 
= ! use ( home invasive & non9vasive    

v5tilators = individuals enroll$ "u "p  
,b diagnos$ ) respiratory failure & =   
su* individuals n diagnos$ ) respiratory
 failure2 &  7iv7 any o!r aspects ( home
 v5tilators & simil> devices t !        
te*nical exp]t panel det]m9es are       
appropriate to ensure access to m$ically
 appropriate devices4  7,c7 ,memb]%ip ,9
 e/abli%+ ! te*nical exp]t panel1 !     
,secret>y %all solicit recomm5dations f 
int]e/$ /akehold]s4 ,! te*nical exp]t   
panel %all be compos$ ( a m9imum ( #ae  
individuals ) relevant exp]tise &       
p]spectives1 includ+ ! foll[+3  7i7     
,home invasive & non9vasive v5tilator   
pati5ts & c>egiv]s4  7ii7 ,exp]ts )     
relevant cl9ical exp]i5ce & exp]tise1   
includ+ rese>*]s 9 respiratory c>e1     
pulmonologi/s1 nurses1 respiratory      
!rapi/s1 & o!r cl9icians4  7iii7 ,exp]ts
 ) subject matt] exp]tise 9 reimbursem5t
 sy/ems & m$ical necessity requirem5ts  
"u ?is title4  7iv7 ,exp]ts 9 ! supply (
 devices & s]vices = home v5tilation    
!rapy4  7v7 ,exp]ts 9 ! design1         

developm5t1 & manufactur+ ( home        
v5tilation equipm5t4  7,d7 ,use ( !     
recomm5dations by ! secret>y  7i7 ,9    
g5]al ,9 consultation ) /akehold]s1 !   
,secret>y %all1 bas$ ^u ! recomm5dations
 describ$ 9 subp>agraph 7,b71 update    
national cov]age det]m9ations =         
v5tilators & devices describ$ 9 p>agraph
 7#a74  7ii7 ,tim+ ,! ,secret>y %all    
f9alize & implem5t updat$ national      
cov]age det]m9ations describ$ 9 clause  
7i71 tak+ into acc\nt public comm5ts    
made dur+ ! det]m9ation process1 n lat] 
?an #i mon?s aft] any date on :i* !     
,secret>y receives recomm5dations       
describ$ 9 subp>agraph 7,b7 f ! te*nical
 exp]t panel4  7,e7 ,transp>5cy ,!      
,secret>y %all make ! m9utes ( all      
meet+s ( ! te*nical exp]t panel & all   
docum5tation relat+ to ! =mulation (    
recomm5dations describ$ 9 subp>agraph   
7,b7 available to ! public ?r\gh !      
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices     
website4  4