,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #ecie  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,septemb] #ab1        
#bjbc,mrs4 ,h>%b>g] introduc$ ! foll[+  
bill2 :i* 0 ref]r$ to ! ,committee on   
,ways & ,means1 & 9 addition to !       
,committee on ,en]gy & ,comm]ce1 = 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 e/abli% a demon/ration program      
relat+ to m$ical necessity det]m9ations 
"u ! ,m$ic>e program4  #a4 ,%ort title  
,?is ,act may be cit$ z ! ,cov]age      
,p>ity = ,m$ic>e ,pati5ts ,act ( #bjbc4 
#b4 ,e/abli%+ a demon/ration program    
relat+ to m$ical necessity det]m9ations 
"u ! ,m$ic>e program ,section #ahfb ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciey7 is am5d$ by add+ at ! end !     
foll[+ new subsection3  7p7             
,demon/ration program relat+ to m$ical  
necessity det]m9ations  7#a7 ,9 g5]al ,n

 lat] ?an ,janu>y #a1 #bjbf1 ! ,secret>y
 %all e/abli% a demon/ration program 79 
?is subsection ref]r$ to z ! program7 "u
 :i* an item or s]vice furni%$ to an    
individual entitl$ to b5efits "u "p ,a  
or enroll$ "u "p ,b is deem$ to be      
reasonable & necess>y = purposes (      
subsection 7a77#a7 if su* item or s]vice
 meets ! crit]ia specifi$ 9 p>agraph    
7#c74  7#b7 ,selection ( p>ticipat+     
areas ,! ,secret>y %all select no few]  
?an #e ,/ates 7or1 at ! option ( !      
,secret>y1 no few] ?an #c ,m$ic>e       
adm9i/rative contractor jurisdictions   
relat+ to ! adm9i/ration ( p>ts ,a & ,b 
7z specifi$ by ! ,secret>y77 9 :i* to   
c>ry out ! program4  7#c7 ,specifi$     
crit]ia  7,a7 ,9 g5]al ,= purposes (    
p>agraph 7#a71 ! crit]ia specifi$ 9 ?is 
p>agraph are1 ) respect to an item or   
s]vice furni%$ to an individual 9 a     
,/ate or jurisdiction 7z applicable7    
select$ by ! ,secret>y "u p>agraph 7#b71
 ! foll[+3 7i7 ,su* item or s]vice s    
furni%$ w\ld be cov]$ "u a significant  

numb] ( gr\p heal? plans & gr\p or      
individual heal? insurance cov]age (f]$ 
9 su* ,/ate or jurisdiction if s furni%$
 to a simil>ly situat$ individual       
enroll$ "u su* plan or cov]age 7z       
applicable74  7ii7 ,! item or s]vice is 
safe & effective4  7iii7 ,! item or     
s]vice--  7,i7 is n exp]im5tal or       
inve/igational2 or  7,,ii7 is exp]im5tal
 or inve/igational1 b is furni%$ z "p ( 
a cl9ical trial t meets ! /&>ds (       
cov]age applicable "u any national      
cov]age det]m9ation relat+ to cl9ical   
trials4  7,b7 ,significant cov]age ,!   
,secret>y %all ?r\gh notice-&-comm5t    
rulemak+ e/abli% requirem5ts = :at      
con/itutes cov]age ( an item or s]vice  
"u a significant numb] ( gr\p heal?     
plans & gr\p or individual heal?        
insurance cov]age 9 a ,/ate or          
jurisdiction4 ,su* requirem5ts may      
provide t su* significant numb] is      
demon/rat$ ?r\gh a %[+ t a majority (   
simil>ly situat$ individuals cov]$ "u   
su* a plan or gr\p or individual heal?  

insurance cov]age 9 su* ,/ate or        
jurisdiction w\ld h b5efits available "u
 su* plan or cov]age = su* item or      
s]vice or ?r\gh su* o!r simil> metrics  
det]m9$ appropriate by ! ,secret>y4     
7#d7 ,duration  7,a7 ,9 g5]al ,! program
 %all be 9 effect = a p]iod ( n less ?an
 #d ye>s4  7,b7 ,expansion ,! ,secret>y 
may1 dur+ ! p]iod 9 :i* ! program is 9  
effect & z det]m9$ appropriate by !     
,secret>y1 exp& ! program to additional 
,/ates or jurisdictions n orig9ally     
select$ "u p>agraph 7#b74  7,c7         
,t]m9ation ,! ,secret>y may t]m9ate !   
program--  7i7 only on or aft] ! date t 
is #d ye>s aft] ! effective date ( !    
program2 &  7ii7 only once ! ,secret>y  
has conclud$ a #fj-;day public comm5t   
p]iod ) respect to su* t]m9ation4  4