#aah? ,,congress  #b;d ,session  ,h4 ,r4
 #eebf  ,,an ,,act  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
cl>ify ! application ( ! 9-(fice        
ancill>y s]vices exception to !         
physician self-ref]ral prohibition =    
cov]$ outpati5t drugs furni%$ "u !      
,m$ic>e program1 & to provide cov]age ( 
ext]nal infusion pumps &                
non-self-adm9i/rable home infusion drugs
 "u su* program4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,s5iors' ,access to
 ,critical ,m$ications ,act ( #bjbd4    
#b4 ,cl>ify+ ! application ( ! 9-(fice  
ancill>y s]vices exception to !         
physician self-ref]ral prohibition =    
cov]$ outpati5t drugs furni%$ "u !      
,m$ic>e program  7a7 ,9 g5]al ,section  
#ahgg7;b77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acienn7b77#b77 is am5d$
 by add+ at ! end ! foll[+ new s5t5ce3  
,) respect to s]vices describ$ 9        
subsection 7h77#f77;,j7 consi/+ ( cov]$ 
"p ,d drugs 7z def9$ 9 section          
#ahfj;,d-#b7;e77 furni%$ to an          

individual dur+ ! p]iod beg9n+ on       
,janu>y #a1 #bjbe1 & end+ on ,decemb]   
#ca1 #bjbi1 su* drugs %all be treat$ z  
hav+ be5 furni%$ 9 accordance )         
subp>agraph 7,a77ii7 if su* drugs are   
pick$ up 9 a build+ describ$ 9 subclause
 7,i7 or 7,,ii7 ( su* subp>agraph by su*
 individual1 or a family memb] or       
c>egiv] on behalf ( su* individual1 or  
deliv]$ to su* individual by a mail1    
deliv]y1 or c\ri] s]vice1 b only if1    
dur+ ! #a-ye> p]iod end+ on ! date su*  
drugs 7 s furni%$1 su* individual _h a  
face-to-face enc\nt] ) ! prescrib] ( su*
 drugs 7n includ+ any su* enc\nt]       
conduct$ via teleheal?71 & only if su*  
prescrib] 7or ano!r physician or        
practition] 7z describ$ 9 section       
#ahdb7;b77#ah77;,c77 9 ! same practice z
 su* prescrib] 7z det]m9$ by tax        
id5tification numb]77 furni%$ to su*    
individual1 dur+ su* #a-ye> p]iod1 ano!r
 item or s]vice = :i* paym5t 0 made "u  
?is title1 & only if su* individual has 
an ongo+ relation%ip ) su* prescrib]44  

7b7 ,report ,n lat] ?an #c ye>s aft] !  
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,heal? & ,human ,s]vices    
%all submit to ,congress a report t     
conta9s-- 7#a7 ! numb] ( individuals :o 
7 furni%$ drugs 9 a mann] t w\ld        
con/itute a violation ( section #ahgg ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acienn7 b = ! am5dm5t made by          
subsection 7a72  7#b7 an analysis ( !   
*ange 9 exp5ditures "u title ,,xviii (  
su* ,act 7#db ,u4,s4,c4 #acie et seq47  
attributable to su* am5dm5t2  7#c7 a    
description ( :i* drugs 7 furni%$ 9 a   
mann] describ$ 9 p>agraph 7#a72 &  7#d7 
su* am5dm5t's impact on prices = su*    
drugs4  #c4 ,m$ic>e cov]age ( ext]nal   
infusion pumps & non-self-adm9i/rable   
home infusion drugs ,section #ahfa7n7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciex7n77 is am5d$ by add+ at ! end !  
foll[+ new s5t5ce3  ,beg9n+ ) ! fir/    
cal5d> qu>t] beg9n+ on or aft] ! date t 
is "o ye> aft] ! date ( ! enactm5t ( !  
,s5iors' ,access to ,critical           

,m$ications ,act ( #bjbd1 an ext]nal    
infusion pump & associat$ home infusion 
drug 7z def9$ 9 subsection              
7iii77#c77;,c77 or o!r associat$        
supplies t d n meet ! appropriate = use 
9 ! home requirem5t appli$ to !         
def9ition ( durable m$ical equipm5t "u  
section #dad4bjb ( title #db1 ,code (   
,f$]al ,regulations 7or any successor to
 su* regulation7 %all be treat$ z meet+ 
su* requirem5t if ea* ( ! foll[+ crit]ia
 is satisfi$3 7#a7 ,! prescrib+         
in=mation approv$ by ! ,food & ,drug    
,adm9i/ration = ! home infusion drug    
associat$ ) ! pump in/ructs t ! drug    
%\ld be adm9i/]$ by or "u ! sup]vision (
 a heal? c>e pr(essional4  7#b7 ,a      
qualifi$ home infusion !rapy suppli] 7z 
def9$ 9 subsection 7iii77#c77;,d77      
adm9i/]s or sup]vises ! adm9i/ration ( !
 drug or biological 9 a safe & effective
 mann] 9 ! pati5t's home 7z def9$ 9     
subsection 7iii77#c77;,b774  7#c7 ,!    
prescrib+ in=mation describ$ 9 p>agraph 
7#a7 in/ructs t ! drug %\ld be infus$ at

 lea/ #ab times p] ye>--  7,a7          
intrav5\sly or subcutane\sly2 or  7,b7  
at infusion rates t ! ,secret>y det]m9es
 w\ld require ! use ( an ext]nal        
infusion pump4  4  #d4 ,m$ic>e          
,improvem5t ,fund ,section #ahih7;b77#a7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acie;iii7b77#a77 is am5d$ by 
/rik+ #j & ins]t+ #aad1jjj1jjj4  ,pass$ 
! ,h\se ( ,repres5tatives ,septemb] #bc1
 #bjbd4;,cl]k4