,,ii #aahth ,,congress #b;d ,session ,s4 #cigg ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ai1 #bjbd,mr4 ,warner 7for himself1 ,mr4 ,daines1 ,ms4 ,klobuchar1 and ,mr4 ,cornyn7 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 protect beneficiaries with limb loss and other orthopedic conditions by providing access to appropriate1 safe1 effective1 patient-centered orthotic and prosthetic care2 to reduce fraud1 waste1 and abuse with respect to orthotics and prosthetics1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,medicare ,orthotics and ,prosthetics ,patient-,centered ,care ,act4 #b4 ,increasing protections for ,medicare beneficiaries receiving orthotic and prosthetic care 7a7 ,prohibition on payment for items delivered by drop shipment 7#a7 ,in general ,section #ahcd7;h77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7h77#a77 is amended by adding at the end the following new subparagraph3 7,i7 ,prohibition on payment for certain items furnished using a drop shipment 7i7 ,in general ,no payment shall be made under this subsection for an item described in clause 7ii7 furnished to an individual via a drop shipment4 7ii7 ,items described ,this items described in this clause are the following3 7,i7 ,a prosthesis 7as defined in paragraph 7#d77;,c771 except that such term does not include supplies for such prosthesis4 7,,ii7 ,a custom-fabricated orthosis 7as described in subparagraph 7,f77ii771 or a custom-fitted orthosis1 except that such term does not include supplies for such orthosis4 7,,iii7 ,off-the-shelf orthotics 7as defined in section #ahdg7;a77#b77;,c77 that are not otherwise subject to competitive bidding and are delivered by drop shipment4 7iii7 ,drop shipment defined ,in this subparagraph1 the term drop shipment means the direct shipment of a prosthesis or an orthosis to an individual that has not received training or education with respect to fitting and adjustment or training in the care and use of such prosthesis or orthosis from a qualified practitioner 7as described in subparagraph 7,f77iii774 4 7#b7 ,effective date ,the amendment made by paragraph 7#a7 shall apply to items furnished on or after the first day of the first full calendar year following the date of enactment of this ,act4 7b7 ,additional practitioners exempt from competitive acquisition ,section #ahdg7;a77#g77;,a77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#c7;a77#g77;,a77i77 is amended-- 7#a7 by inserting 1 physical therapist1 occupational therapist1 orthotist1 prosthetist after by a physician2 and 7#b7 by inserting 1 physical therapist1 occupational therapist1 orthotist1 prosthetist after the physician's in each place such term occurs4 7c7 ,ensuring beneficiary access to replacement custom-,fitted orthotic devices and custom-,fabricated orthotic devices ,section #ahcd7;h77#a77;,g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7h77#a77;,g77 is amended-- 7#a7 in the heading1 by inserting 1 custom-fitted orthotic devices1 custom-fabricated orthotic devices1 after ,replacement of prosthetic devices2 and 7#b7 in clause 7i71 by inserting 1 replacement of custom-fitted orthotic devices1 replacement of custom-fabricated orthotic devices1 after which are artificial limbs14 7d7 ,updating definitions of orthotics and prosthetics ,section #ahcd7;h77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7h77#d77;,c77 is amended by striking the term orthotics and prosthetics has the meaning given such term1 and inserting the terms orthotics and prosthetics and orthoses and prostheses have the meaning given such terms4 7e7 ,regulations ,not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall promulgate final regulations to implement the amendments made by this ,act4