,,ii  #aaith ,,congress  #ast ,session  
,s4 #bcbi  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #ag1     
#bjbe,mr4 ,warner 7for himself and ,mr4 
,daines7 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
 care1 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 ,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 may be made 
under this subsection for an item       
described in clause 7ii7 furnished to an
 individual via a drop shipment on or   
after the first day of the first year   
beginning after the date of the         
enactment of this subparagraph4  7ii7   
,items described ,the items described in
 this clause are orthotics and          
prosthetics1 not including supplies for 
such orthotics and prosthetics1 that are
 identified by ,,hcpcs codes for which  
payment is not made under section #ahdg4
  7iii7 ,drop shipment defined ,in this 
subparagraph1 the term drop shipment    
means1 with respect to an item described
 in clause 7ii71 the direct shipment of 
such item to an individual who has not  
received training or education from a   
qualified practitioner 7as defined in   

subparagraph 7,f77iii77 on the fitting  
and adjustment1 care1 and use of such   
item4  4  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      
prosthetist1 after by a physician2 and  
7#b7 by striking the physician's each   
place it appears and inserting such     
physician's in each such place4  7c7    
,ensuring beneficiary access to         
replacement custom-,fitted orthotics 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 orthotics1                
custom-fabricated orthotics1 after      
,replacement of prosthetic devices2 and 
7#b7 in clause 7i71 by inserting        
replacement of custom-fitted orthotics1 

replacement of items of                 
custom-fabricated orthotics described in
 subparagraph 7,f77ii71 after which are 
artificial limbs14  7d7 ,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 section4