To amend title XVIII of the Social Security Act to provide for additional requirements with respect to electrodiagnostic services under the Medicare program.

I 116TH CONGRESS 2D SESSION H. R. 8780 To amend title XVIII of the Social Security Act to provide for additional requirements with respect to electrodiagnostic services under the Medi- care program. IN THE HOUSE OF REPRESENTATIVES NOVEMBER 18, 2020 Mr. WALDEN (for himself and Ms. BLUNT ROCHESTER) introduced the fol- lowing bill; which was referred to the Committee on Energy and Com- merce, and in addition to the Committee on Ways and Means, for a pe- riod to be subsequently determined by the Speaker, in each case for con- sideration of such provisions as fall within the jurisdiction of the com- mittee concerned A BILL To amend title XVIII of the Social Security Act to provide for additional requirements with respect to electrodiag- nostic services under the Medicare program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. ADDITIONAL REQUIREMENTS FOR ELECTRODI- 3 AGNOSTIC SERVICES. 4 Section 1834 of the Social Security Act (42 U.S.C. 5 1395m) is amended by adding at the end the following 6 new subsection: 7 VerDate Sep 11 2014 06:16 Nov 30, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8780.IH H8780 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 8780 IH ‘‘(x) PAYMENT FOR ELECTRODIAGNOSTIC SERV- 1 ICES.— 2 ‘‘(1) IN GENERAL.—No payment may be made 3 under this part for electrodiagnostic services de- 4 scribed in paragraph (2) furnished on or after a date 5 determined appropriate by the Secretary that is not 6 less than 3 years after the date of the enactment of 7 this subsection and not later than 4 years after such 8 date of enactment that are not furnished at a quali- 9 fied facility. 10 ‘‘(2) ELECTRODIAGNOSTIC SERVICES.—The 11 services described in this paragraph are the fol- 12 lowing: 13 ‘‘(A) Nerve conduction studies. 14 ‘‘(B) Needle electromyography tests. 15 ‘‘(3) QUALIFIED FACILITY.—In this subsection, 16 the term ‘qualified facility’ means a facility accred- 17 ited by an organization specified by the Secretary 18 pursuant to paragraph (4). 19 ‘‘(4) ACCREDITATION ORGANIZATIONS.— 20 ‘‘(A) IN GENERAL.—Not later than 2 years 21 after the date of the enactment of this sub- 22 section, the Secretary shall specify one or more 23 accrediting organizations, in consultation with 24 the advisory committee described in paragraph 25 VerDate Sep 11 2014 06:16 Nov 30, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8780.IH H8780 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 8780 IH (5), for purposes determining whether a facility 1 is a qualified facility. The Secretary may speci- 2 fy an organization pursuant to the preceding 3 sentence only if such organization requires, as 4 a condition of accreditation of a facility by such 5 organization, that such facility meet the re- 6 quirements described in subparagraph (B). 7 ‘‘(B) FACILITY REQUIREMENTS.—The re- 8 quirements described in this subparagraph are, 9 with respect to a facility and electrodiagnostic 10 services furnished at such facility, the following: 11 ‘‘(i) The facility establishes and main- 12 tains a quality assurance and control pro- 13 gram to ensure the reliability, safety, and 14 accuracy of such service. 15 ‘‘(ii) The facility ensures that such 16 service is conducted using a device capable 17 of performing both nerve conduction stud- 18 ies that record amplitude and latency and 19 needle electromyography tests capable of 20 real-time waveform display and analysis. 21 ‘‘(iii) In the case that such service is 22 a needle electromyography test, the facility 23 ensures that the physician furnishing such 24 test has completed not less than three 25 VerDate Sep 11 2014 06:16 Nov 30, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8780.IH H8780 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 8780 IH months of training in furnishing 1 electrodiagnostic services through a resi- 2 dency or fellowship program accredited by 3 the Accreditation Council for Graduate 4 Medical Education or the Royal College of 5 Physicians and Surgeons of Canada. 6 ‘‘(iv) The facility ensures that the re- 7 sults are interpreted on-site and at the 8 time of the procedure— 9 ‘‘(I) in the case of a needle 10 electromyography test, by the physi- 11 cian who performed such test; and 12 ‘‘(II) in the case of a nerve con- 13 duction study, by the physician who 14 performed or supervised such study. 15 ‘‘(v) Any other requirement deter- 16 mined appropriate by the Secretary. 17 ‘‘(C) REGULATIONS.—Not later than 1 18 year after the date of the enactment of this 19 subsection, the Secretary shall finalize regula- 20 tions that outline— 21 ‘‘(i) the process by which an accred- 22 iting organization may be specified under 23 subparagraph (A); 24 VerDate Sep 11 2014 06:16 Nov 30, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8780.IH H8780 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 8780 IH ‘‘(ii) the duration and the minimum 1 time period between reviews for reaccredi- 2 tation an organization so specified must 3 provide for with respect to an accreditation 4 of a facility made by such organization; 5 ‘‘(iii) the process by which the Sec- 6 retary may withdraw approval of an ac- 7 crediting organization so specified if the 8 Secretary determines that such organiza- 9 tion no longer requires, as a condition of 10 accreditation of a facility by such organiza- 11 tion, that such facility meet the require- 12 ments described in subparagraph (B); and 13 ‘‘(iv) the effect such a withdrawal will 14 have on facilities accredited by such orga- 15 nization as of the date of such withdrawal. 16 ‘‘(5) ADVISORY COMMITTEE.— 17 ‘‘(A) IN GENERAL.—Not later than 2 years 18 after the date of the enactment of this sub- 19 section, the Secretary shall establish an advi- 20 sory committee to be known as the ‘National 21 Electrodiagnostic Services Advisory Committee’ 22 (in this subsection referred to as the ‘com- 23 mittee’) for purposes of carrying out the duties 24 specified in subparagraph (B). 25 VerDate Sep 11 2014 06:16 Nov 30, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8780.IH H8780 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 8780 IH ‘‘(B) DUTIES.—The duties of the com- 1 mittee are the following: 2 ‘‘(i) To provide to the Secretary rec- 3 ommendations with respect to require- 4 ments that may be determined appropriate 5 by the Secretary pursuant to paragraph 6 (4)(B)(v), including any proposed additions 7 to such requirements or modifications of 8 such requirements. In developing such rec- 9 ommendations, the committee shall 10 prioritize— 11 ‘‘(I) reducing unnecessary treat- 12 ments and surgeries; 13 ‘‘(II) decreasing the need for re- 14 testing of individuals; 15 ‘‘(III) enhancing the reliability of 16 diagnoses and promoting positive 17 health outcomes for individuals; 18 ‘‘(IV) addressing emerging waste, 19 fraud, and abuse schemes; and 20 ‘‘(V) otherwise improving the 21 quality of care for individuals. 22 ‘‘(ii) To provide to the Secretary rec- 23 ommendations regarding the regulations 24 described in paragraph (4)(C). 25 VerDate Sep 11 2014 06:16 Nov 30, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8780.IH H8780 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 8780 IH ‘‘(iii) To provide to the Secretary rec- 1 ommendations with respect to whether ac- 2 crediting organizations seeking to be speci- 3 fied pursuant to paragraph (4)(A) should 4 be so specified. 5 ‘‘(C) COMPOSITION.—The committee shall 6 be composed of not fewer than 9 and not more 7 than 11 individuals selected by the Secretary. 8 Such individuals shall not be officers or employ- 9 ees of the Federal Government and shall in- 10 clude— 11 ‘‘(i) physicians; 12 ‘‘(ii) other health care practitioners; 13 and 14 ‘‘(iii) other individuals determined ap- 15 propriate by the Secretary. 16 ‘‘(D) MEETINGS.—The committee shall 17 convene not less than twice each year.’’. 18 Æ VerDate Sep 11 2014 06:16 Nov 30, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H8780.IH H8780 pbinns on DSKJLVW7X2PROD with BILLS