Sec. 11407. Limitation on monthly coinsurance and adjustments to supplier payment under Medicare Part B for insulin furnished through durable medical equipment
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/bill/117/hr/5376/eas/section-11407·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The first sentence of section 1833(b) of the Social Security Act ( 42 U.S.C. 1395l(b) ) is amended— by striking and
(12)and inserting
(12); and by inserting before the period the following: , and
(13)such deductible shall not apply with respect to insulin furnished on or after July 1, 2023, through an item of durable medical equipment covered under section 1861(n). . Section 1833(a)(1)(S) of the Social Security Act ( 42 U.S.C. 1395l(a)(1)(S) ) is amended— by inserting
(i)except as provided in clause (ii), after
(S); and by inserting after or 1847B), the following: and
(ii)with respect to insulin furnished on or after July 1, 2023, through an item of durable medical equipment covered under section 1861(n), the amounts paid shall be, subject to the fourth sentence of this subsection, 80 percent of the payment amount established under section 1847A (or section 1847B, if applicable) for such insulin, . Section 1833(a) of the Social Security Act ( 42 U.S.C. 1395l(a) ) is amended, in the flush matter at the end, by adding at the end the following new sentence: The Secretary shall make such adjustments as may be necessary to the amounts paid as specified under paragraph (1)(S)(ii) for insulin furnished on or after July 1, 2023, through an item of durable medical equipment covered under section 1861(n), such that the amount of coinsurance payable by an individual enrolled under this part for a month’s supply of such insulin does not exceed $35. . The Secretary of Health and Human Services shall implement this section for 2023 by program instruction or other forms of program guidance.
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Sec. 11407
Limitation on monthly coinsurance and adjustments to supplier payment under Medicare Part B for insulin furnished through durable medical equipment
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