IB Union Calendar No. 302 116TH CONGRESS 2D SESSION H. R. 4618 [Report No. 116–326, Parts I and II] To amend title XVIII of the Social Security Act to provide coverage for certain hearing items and services under part B of the Medicare program. IN THE HOUSE OF REPRESENTATIVES OCTOBER 8, 2019 Mrs. MCBATH (for herself and Mrs. DINGELL) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subse- quently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned DECEMBER 6, 2019 Reported from the Committee on Ways and Means with an amendment [Strike out all after the enacting clause and insert the part printed in italic] JANUARY 24, 2020 Additional sponsors: Ms. CASTOR of Florida, Mr. CUELLAR, Ms. NORTON, Mr. HIGGINS of New York, and Mr. WELCH JANUARY 24, 2020 Reported from the Committee on Energy and Commerce, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed [For text of introduced bill, see copy of bill as introduced on October 8, 2019] VerDate Sep 11 2014 00:25 Jan 25, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS 2 •HR 4618 RH A BILL To amend title XVIII of the Social Security Act to provide coverage for certain hearing items and services under part B of the Medicare program. VerDate Sep 11 2014 23:41 Jan 24, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6652 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS 3 •HR 4618 RH Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Medicare Hearing Act 4 of 2019’’. 5 SEC. 2. PROVIDING COVERAGE FOR HEARING CARE UNDER 6 THE MEDICARE PROGRAM. 7 (a) PROVISION OF AURAL REHABILITATION AND 8 TREATMENT SERVICES BY QUALIFIED AUDIOLOGISTS.— 9 Section 1861(ll)(3) of the Social Security Act (42 U.S.C. 10 1395x(ll)(3)) is amended by inserting ‘‘(and, beginning 11 January 1, 2022, such aural rehabilitation and treatment 12 services)’’ after ‘‘assessment services’’. 13 (b) COVERAGE OF HEARING AIDS.— 14 (1) INCLUSION OF HEARING AIDS AS PROS- 15 THETIC DEVICES.—Section 1861(s)(8) of the Social 16 Security Act (42 U.S.C. 1395x(s)(8)) is amended by 17 inserting ‘‘, and including hearing aids furnished on 18 or after January 1, 2022, to individuals diagnosed 19 with profound or severe hearing loss’’ before the semi- 20 colon at the end. 21 (2) PAYMENT LIMITATIONS FOR HEARING 22 AIDS.—Section 1834(h) of the Social Security Act (42 23 U.S.C. 1395m(h)) is amended by adding at the end 24 the following new paragraph: 25 VerDate Sep 11 2014 23:41 Jan 24, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6203 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS 4 •HR 4618 RH ‘‘(6) LIMITATIONS FOR HEARING AIDS.—Pay- 1 ment may be made under this part with respect to an 2 individual, with respect to hearing aids furnished on 3 or after January 1, 2022— 4 ‘‘(A) not more than once during any 5-year 5 period; 6 ‘‘(B) only for types of such hearing aids 7 that are not over-the-counter hearing aids (as de- 8 fined in section 520(q)(1) of the Federal Food, 9 Drug, and Cosmetic Act) and that are deter- 10 mined appropriate by the Secretary; and 11 ‘‘(C) only if furnished pursuant to a writ- 12 ten order of a physician or qualified audiologist 13 (as defined in section 1861(ll)(4)(B)).’’. 14 (3) APPLICATION OF COMPETITIVE ACQUISI- 15 TION.— 16 (A) IN GENERAL.—Section 1834(h)(1)(H) of 17 the Social Security Act (42 U.S.C. 18 1395m(h)(1)(H)) is amended— 19 (i) in the header, by inserting ‘‘AND 20 HEARING AIDS’’ before the semicolon; 21 (ii) by inserting ‘‘and of hearing aids 22 described in paragraph (2)(D) of such sec- 23 tion,’’ after ‘‘2009,’’; and 24 VerDate Sep 11 2014 23:41 Jan 24, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6203 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS 5 •HR 4618 RH (iii) in clause (i), by inserting ‘‘or 1 such hearing aids’’ after ‘‘such orthotics’’. 2 (B) CONFORMING AMENDMENT.— 3 (i) IN GENERAL.—Section 1847(a)(2) 4 of the Social Security Act (42 U.S.C. 5 1395w–3(a)(2)) is amended by adding at 6 the end the following new subparagraph: 7 ‘‘(D) HEARING AIDS.—Hearing aids for 8 which payment would otherwise be made under 9 section 1834(h).’’. 10 (ii) EXEMPTION OF CERTAIN ITEMS 11 FROM COMPETITIVE ACQUISITION.—Section 12 1847(a)(7) of the Social Security Act (42 13 U.S.C. 1395w–3(a)(7)) is amended by add- 14 ing at the end the following new subpara- 15 graph: 16 ‘‘(C) CERTAIN HEARING AIDS.—Those items 17 and services described in paragraph (2)(D) if 18 furnished by a physician or other practitioner 19 (as defined by the Secretary) to the physician’s 20 or practitioner’s own patients as part of the phy- 21 sician’s or practitioner’s professional service.’’. 22 (4) INCLUSION OF AUDIOLOGISTS AS CERTAIN 23 PRACTITIONERS TO RECEIVE PAYMENT ON AN ASSIGN- 24 MENT-RELATED BASIS.—Section 1842(b)(18)(C) of the 25 VerDate Sep 11 2014 23:41 Jan 24, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6203 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS 6 •HR 4618 RH Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is 1 amended by adding at the end the following new 2 clause: 3 ‘‘(vii) With respect to 2022 and each 4 subsequent year, a qualified audiologist (as 5 defined in section 1861(ll)(4)(B)).’’. 6 (c) EXCLUSION MODIFICATION.—Section 1862(a)(7) of 7 the Social Security Act (42 U.S.C. 1395y(a)(7)) is amended 8 by inserting ‘‘(except such hearing aids or examinations as 9 described in and otherwise allowed under section 10 1861(s)(8))’’ after ‘‘hearing aids or examinations therefor’’. 11 SEC. 3. IMPLEMENTATION FUNDING. 12 The Secretary of Health and Human Services shall 13 provide for the transfer from the Federal Supplementary 14 Medical Insurance Trust Fund under section 1841 of the 15 Social Security Act (42 U.S.C. 1395t) to the Centers for 16 Medicare & Medicaid Services Program Management Ac- 17 count for the period of 2020 through 2024 of such sums as 18 may be necessary for purposes of implementing the amend- 19 ments made by section 2. 20 SEC. 4. REPORT. 21 (a) REPORT.—Not later than the date that is 2 years 22 after the date of the enactment of the Medicare Hearing Act 23 of 2019, the Inspector General of the Department of Health 24 and Human Services shall— 25 VerDate Sep 11 2014 23:41 Jan 24, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6203 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS 7 •HR 4618 RH (1) determine the feasibility of qualified audiol- 1 ogists (as defined in paragraph (4)(B) of 1861(ll) of 2 the Social Security Act (42 U.S.C. 1395x(ll))) fur- 3 nishing audiology services (as defined in paragraph 4 (3) of such section) to individuals entitled to benefits 5 under part A of title XVIII of such Act (42 U.S.C. 6 1395c et seq.) and enrolled for benefits under part B 7 of such title (42 U.S.C.1395j et seq.) without such in- 8 dividuals being referred by a physician (as defined in 9 section 1861(r) of such Act (42 U.S.C. 1395x(r))) or 10 practitioner (as described in section 1842(b)(18)(C) of 11 such Act (42 U.S.C. 1395u(b)(18)(C))) to qualified 12 audiologists; and 13 (2) submit to the Secretary of Health and 14 Human Services a report on the feasibility of the re- 15 ferral described in paragraph (1) and any program 16 integrity or overutilization concerns with respect to 17 such referral. 18 (b) REGULATIONS.—The Secretary of Health and 19 Human Services may promulgate regulations to allow 20 qualified audiologists to furnish audiology services without 21 a referral from a physician or practitioner, consistent with 22 the findings submitted to the Secretary pursuant to sub- 23 section (a)(2). 24 VerDate Sep 11 2014 23:41 Jan 24, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6203 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS Union Calendar No. 302 116TH CONGRESS 2D SESSION H. R. 4618 [Report No. 116–326, Parts I and II] A BILL To amend title XVIII of the Social Security Act to provide coverage for certain hearing items and services under part B of the Medicare program. JANUARY 24, 2020 Reported from the Committee on Energy and Commerce, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed VerDate Sep 11 2014 23:41 Jan 24, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6651 Sfmt 6651 E:\BILLS\H4618.RH H4618 SSpencer on DSKBBXCHB2PROD with BILLS