Sec. 603. Providing coverage for vision care under the Medicare program

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Section 1861(s)(2) of the Social Security Act ( 42 U.S.C. 1395x(s)(2) ), as amended by section 601(a), is further amended— in subparagraph (HH), by striking and after the semicolon at the end; in subparagraph (II), by striking the period at the end and adding ; and ; and by adding at the end the following new subparagraph: vision services (as defined in subsection (lll)); . Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ), as amended by section 601(b), is further amended by adding at the end the following new subsection:

The term vision services means— routine eye examinations to determine the refractive state of the eyes, including procedures performed during the course of such examination; and contact lens fitting services; furnished on or after January 1, 2023, by or under the direct supervision of an optometrist or ophthalmologist who is legally authorized to furnish such examinations, procedures, or fitting services (as applicable) under State law (or the State regulatory mechanism provided by State law) of the State in which the examinations, procedures, or fitting services are furnished. .

Section 1834 of the Social Security Act ( 42 U.S.C. 1395m ), as amended by section 601(c)(2), is further amended by adding at the end the following new subsection: With respect to vision services (as defined in section 1861(lll)) and an individual, payment may be made under this part for only 1 routine eye examination described in paragraph

(1)of such section and 1 contact lens fitting service described in paragraph

(2)of such section during a 2-year period. . Section 1848(j)(3) of the Social Security Act ( 42 U.S.C. 1395w–4(j)(3) ), as amended by section 601(d)(1), is further amended by inserting (2)(JJ), before

(3). Section 1861(s)(8) of the Social Security Act ( 42 U.S.C. 1395x(s)(8) ), as amended by section 602(b)(1), is further amended by striking , and including one pair of conventional eyeglasses or contact lenses furnished subsequent to each cataract surgery with insertion of an intraocular lens and inserting , including one pair of conventional eyeglasses or contact lenses furnished subsequent to each cataract surgery with insertion of an intraocular lens, if furnished before January 1, 2023, including conventional eyeglasses or contact lenses, whether or not furnished subsequent to such a surgery, if furnished on or after January 1, 2024 . Section 1834(h) of the Social Security Act ( 42 U.S.C. 1395m(h) ), as amended by section 601(e)(2)(A) and section 602(b)(2), is further amended by adding at the end the following new paragraph: With respect to eyeglasses and contact lenses furnished to an individual on or after January 1, 2023, subject to subparagraph (B), payment may be made under this part only— during a 2-year period, for either 1 pair of eyeglasses (including lenses and frames) or not more than a 2-year supply of contact lenses that is provided in not more than 180-day increments; with respect to amounts attributable to the lenses and frames of such a pair of eyeglasses or amounts attributable to such a 2-year supply of contact lenses, in an amount not greater than— for a pair of eyeglasses furnished in, or a 2-year supply of contact lenses beginning in, 2023— $85 for the lenses of such pair of eyeglasses and $85 for the frames of such pair of eyeglasses; or $85 for such 2-year supply of contact lenses; and for the lenses and frames of a pair of eyeglasses furnished in, or a 2-year supply of contact lenses beginning in, a subsequent year, the dollar amounts specified under this subparagraph for the previous year, increased by the percentage change in the consumer price index for all urban consumers (United States city average) for the 12-month period ending with June of the previous year; for types of eyeglass lenses, and for types of contact lenses, as determined appropriate by the Secretary; if furnished pursuant to a written order of a physician described in section 1861(lll); and if during the 2-year period described in clause (i), the individual did not already receive (as described in subparagraph (B)) one pair of conventional eyeglasses or contact lenses subsequent to a cataract surgery with insertion of an intraocular lens furnished during such period. With respect to a 2-year period described in subparagraph (A)(i), in the case of an individual who receives cataract surgery with insertion of an intraocular lens, notwithstanding subparagraph (A), payment may be made under this part for one pair of conventional eyeglasses or contact lenses furnished subsequent to such cataract surgery during such period. . 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) and section 602(b)(3)(A), is further amended— in the header by inserting after , eyeglasses, and contact lenses ; hearing aids by inserting and of eyeglasses and contact lenses described in paragraph (2)(F) of such section, after paragraph (2)(E) of such section, ; and in clause (i), by inserting , or such eyeglasses and contact lenses after such hearing aids . 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) and section 602(b)(3)(B)(i), is further amended by adding at the end the following new subparagraph: Eyeglasses and contact lenses 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) and section 602(b)(3)(B)(ii), is further amended by adding at the end the following new subparagraph: Those items and services described in paragraph (2)(F) 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 1862(a) of the Social Security Act ( 42 U.S.C. 1395y(a) ), as amended by section 601(f), is further amended— in paragraph (1)— in subparagraph (P), by striking and at the end; in subparagraph (Q), by striking the semicolon at the end and inserting , and ; and by adding at the end the following new subparagraph: in the case of vision services (as defined in section 1861(lll)) that are routine eye examinations and contact lens fitting services (as described in paragraph

(1)or (2), respectively, of such section), which are furnished more frequently than once during a 2-year period; ; and in paragraph (7)— by inserting (other than such an examination that is a vision service that is covered under section 1861(s)(2)(JJ)) after eye examinations ; and by inserting (other than such a procedure that is a vision service that is covered under section 1861(s)(2)(JJ)) after refractive state of the eyes . 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) and amended by section 602(d)(1), is further amended by inserting , and 603 (other than subsection (h)) after 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) and amended by section 602(d)(2), is further amended by inserting , and 603 (other than subsection (h)) after 602 (other than subsection (d)) . 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 602.

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