Sec. 602. Providing coverage for hearing care under the Medicare program

944 words·~4 min read·/bill/116/hr/3/eh/section-602

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Section 1861(ll)(3) of the Social Security Act ( 42 U.S.C. 1395x(ll)(3) ) is amended by inserting (and, beginning January 1, 2023, such aural rehabilitation and treatment services) after assessment services . Section 1861(s)(8) of the Social Security Act ( 42 U.S.C. 1395x(s)(8) ) is amended by inserting , and including hearing aids furnished on or after January 1, 2023, to individuals diagnosed with profound or severe hearing loss before the semicolon at the end. Section 1834(h) of the Social Security Act ( 42 U.S.C. 1395m(h) ), as amended by section 601(e)(2)(A), is further amended by adding at the end the following new paragraph:

Payment may be made under this part with respect to an individual, with respect to hearing aids furnished on or after January 1, 2023— not more than once during a 5-year period; only for types of such hearing aids that are not over-the-counter hearing aids (as defined in section 520(q)(1) of the Federal Food, Drug, and Cosmetic Act) and that are determined appropriate by the Secretary; and only if furnished pursuant to a written order of a physician or qualified audiologist (as defined in section 1861(ll)(4)(B)). .

Section 1834(h)(1)(H) of the Social Security Act ( 42 U.S.C. 1395m(h)(1)(H) ), as amended by section 601(e)(2)(B)(i), is further amended— in the header, by inserting after , hearing aids ; dentures by inserting , of hearing aids described in paragraph (2)(E) of such section, after paragraph (2)(D) of such section ; and in clause (i), by inserting , such hearing aids after such dentures . Section 1847(a)(2) of the Social Security Act ( 42 U.S.C. 1395w–3(a)(2) ), as amended by section 601(e)(2)(B)(ii), is further amended by adding at the end the following new subparagraph:

Hearing aids described in section 1861(s)(8) for which payment would otherwise be made under section 1834(h). . Section 1847(a)(7) of the Social Security Act ( 42 U.S.C. 1395w–3(a)(7) ), as amended by section 601(e)(2)(B)(iii), is further amended by adding at the end the following new subparagraph: Those items and services described in paragraph (2)(E) if furnished by a physician or other practitioner (as defined by the Secretary) to the physician’s or practitioner’s own patients as part of the physician’s or practitioner’s professional service. .

Section 1842(b)(18)(C) of the Social Security Act ( 42 U.S.C. 1395u(b)(18)(C) ), as amended by section 601(d)(4), is further amended by adding at the end the following new clause: With respect to 2023 and each subsequent year, a qualified audiologist (as defined in section 1861(ll)(4)(B)). . Section 1862(a)(7) of the Social Security Act ( 42 U.S.C. 1395y(a)(7) ) is amended by inserting (except such hearing aids or examinations therefor as described in and otherwise allowed under section 1861(s)(8)) after hearing aids or examinations therefor .

The last sentence of section 1839(a)(1) of the Social Security Act ( 42 U.S.C. 1395r(a)(1) ), as added by section 601(g)(1), is amended by striking section 601 (other than subsection (g)) and inserting sections 601 (other than subsection (g)), 602 (other than subsection (d)) . Paragraph

(4)of section 1844(a) of such Act ( 42 U.S.C. 1395w(a) ), as added by section 601(g)(2), is amended by striking section 601 (other than subsection (g)) and inserting sections 601 (other than subsection (g)), 602 (other than subsection (d)) . Not later than the date that is 3 years after the date of the enactment of this Act, the Inspector General of the Department of Health and Human Services shall conduct a study to assess (and submit to the Secretary of Health and Human Services a report on) any program integrity or overutilization risks with respect to allowing qualified audiologists (as defined in paragraph (4)(B) of 1861(ll) of the Social Security Act ( 42 U.S.C. 1395x(ll) )) to furnish audiology services (as defined in paragraph

(3)of such section) to individuals entitled to benefits under part A of title XVIII of such Act ( 42 U.S.C. 1395c et seq.) and enrolled for benefits under part B of such title (42 U.S.C.1395j et seq.) without such individuals being referred by a physician (as defined in section 1861(r) of such Act ( 42 U.S.C. 1395x(r) )) or practitioner (as described in section 602.32 of title 42, Code of Federal Regulations) to such qualified audiologists. In conducting such study, the Inspector General may take into account experiences with audiologists furnishing audiology services to enrollees in other Federal programs, including in a health benefit plan under chapter 89 of title 5, United States Code or in health care benefits under the TRICARE program under chapter 55 of title 10 of the United States Code or under chapter 17 of title 38 of such Code. The Secretary of Health and Human Services may promulgate regulations to allow qualified audiologists (as so defined) to furnish audiology services (as so defined) without a referral from a physician or practitioner, consistent with the findings submitted to the Secretary pursuant to paragraph (1)(B). The Secretary of Health and Human Services (in this subsection referred to as the Secretary ) shall provide for the transfer from the Federal Supplementary Medical Insurance Trust Fund under section 1841 of the Social Security Act ( 42 U.S.C. 1395t ) to the Centers for Medicare & Medicaid Services Program Management Account of— $20,000,000 for each of fiscal years 2020 through 2024 for purposes of implementing the amendments made by this section; and such sums as determined appropriate by the Secretary for each subsequent fiscal year for purposes of administering the provisions of such amendments. Funds transferred pursuant to paragraph

(1)shall remain available until expended and may be used, in addition to the purpose specified in paragraph (1)(A), to implement the amendments made by sections 601 and 603.

Connectionstraces to 9

Traces to 9 documents

U.S. Code