Us Congress 2023-2024 Regular Session

Us Congress House Bill HB33 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	I
2	2	118THCONGRESS
3	3	1
4	4	STSESSION H. R. 33
5	5	To amend title XVIII of the Social Security Act to provide for coverage
6	6	of dental, vision, and hearing care under the Medicare program.
7	7	IN THE HOUSE OF REPRESENTATIVES
8	8	JANUARY9, 2023
9	9	Mr. D
10	10	OGGETT(for himself, Mrs. BEATTY, Mr. BEYER, Mr. BISHOPof Geor-
11	11	gia, Mr. B
12	12	LUMENAUER, Mr. BOWMAN, Ms. BUSH, Mr. CARSON, Mr. CAR-
13	13	TERof Louisiana, Mr. CARTWRIGHT, Mr. CASAR, Mr. CASTROof Texas,
14	14	Ms. C
15	15	HU, Mr. CLEAVER, Mr. COHEN, Mr. CONNOLLY, Mr. COURTNEY,
16	16	Mr. C
17	17	UELLAR, Ms. DELAURO, Mr. DESAULNIER, Mrs. DINGELL, Ms.
18	18	E
19	19	SCOBAR, Mr. ESPAILLAT, Mr. EVANS, Ms. LEGERFERNANDEZ, Mr.
20	20	G
21	21	ARAMENDI, Mr. GARCI´Aof Illinois, Ms. GARCIAof Texas, Mr. VICENTE
22	22	G
23	23	ONZALEZof Texas, Mr. GOTTHEIMER, Mr. GREENof Texas, Mr. GRI-
24	24	JALVA, Mrs. HAYES, Mr. HIGGINSof New York, Ms. JACKSONLEE, Ms.
25	25	J
26	26	AYAPAL, Mr. JOHNSONof Georgia, Ms. KAPTUR, Mr. KHANNA, Mr. KIM
27	27	of New Jersey, Mr. L
28	28	ARSONof Connecticut, Ms. LEEof California, Mr.
29	29	L
30	30	IEU, Ms. MCCOLLUM, Mr. MCGOVERN, Ms. MENG, Mr. MFUME, Ms.
31	31	M
32	32	OOREof Wisconsin, Mr. NADLER, Mr. NEGUSE, Mr. NORCROSS, Ms.
33	33	N
34	34	ORTON, Ms. OCASIO-CORTEZ, Ms. OMAR, Mr. PASCRELL, Mr. PAYNE,
35	35	Ms. P
36	36	INGREE, Mr. POCAN, Ms. PORTER, Ms. PRESSLEY, Ms. BLUNT
37	37	R
38	38	OCHESTER, Mr. RUIZ, Mr. RUPPERSBERGER, Ms. SCHAKOWSKY, Mr.
39	39	S
40	40	CHIFF, Mr. DAVIDSCOTTof Georgia, Mr. SHERMAN, Mr. SWALWELL,
41	41	Mr. T
42	42	AKANO, Mr. THOMPSONof California, Ms. TITUS, Ms. TLAIB, Mr.
43	43	T
44	44	ONKO, Mr. TORRESof New York, Mrs. TRAHAN, Mr. TRONE, Mr.
45	45	V
46	46	EASEY, Mrs. WATSONCOLEMAN, and Ms. WILLIAMSof Georgia) intro-
47	47	duced the following bill; which was referred to the Committee on Energy
48	48	and Commerce, and in addition to the Committee on Ways and Means,
49	49	for a period to be subsequently determined by the Speaker, in each case
50	50	for consideration of such provisions as fall within the jurisdiction of the
51	51	committee concerned
52	52	A BILL
53	53	To amend title XVIII of the Social Security Act to provide
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56	56	•HR 33 IH
57	57	for coverage of dental, vision, and hearing care under
58	58	the Medicare program.
59	59	Be it enacted by the Senate and House of Representa-1
60	60	tives of the United States of America in Congress assembled, 2
61	61	SECTION 1. SHORT TITLE. 3
62	62	This Act may be cited as the ‘‘Medicare Dental, Vi-4
63	63	sion, and Hearing Benefit Act of 2023’’. 5
64	64	SEC. 2. DENTAL AND ORAL HEALTH CARE. 6
65	65	(a) C
66	66	OVERAGE.—Section 1861(s)(2) of the Social Se-7
67	67	curity Act (42 U.S.C. 1395x(s)(2)) is amended— 8
68	68	(1) in subparagraph (II), by striking ‘‘and’’ 9
69	69	after the semicolon at the end; 10
70	70	(2) in subparagraph (JJ), by adding ‘‘and’’ 11
71	71	after the semicolon at the end; and 12
72	72	(3) by adding at the end the following new sub-13
73	73	paragraph: 14
74	74	‘‘(KK) dental and oral health services (as de-15
75	75	fined in subsection (nnn));’’. 16
76	76	(b) D
77	77	ENTAL AND ORALHEALTHSERVICESDE-17
78	78	FINED.—Section 1861 of the Social Security Act (42 18
79	79	U.S.C. 1395x) is amended by adding at the end the fol-19
80	80	lowing new subsection: 20
81	81	‘‘Dental and Oral Health Services 21
82	82	‘‘(nnn) The term ‘dental and oral health services’ 22
83	83	means— 23
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87	87	‘‘(1) preventative and screening services, such 1
88	88	as oral exams, dental cleanings, dental x-rays, and 2
89	89	fluoride treatments; 3
90	90	‘‘(2) basic dental services, such as tooth res-4
91	91	torations, basic periodontics services, tooth extrac-5
92	92	tions, and oral disease management services; 6
93	93	‘‘(3) major dental services, such as major tooth 7
94	94	restorations, major periodontics services, bridges, 8
95	95	crowns, root canals, and extractions; 9
96	96	‘‘(4) emergency dental care; and 10
97	97	‘‘(5) other necessary services related to dental 11
98	98	or oral health (as defined by the Secretary).’’. 12
99	99	(c) P
100	100	AYMENT; COINSURANCE; ANDLIMITATIONS.— 13
101	101	(1) I
102	102	N GENERAL.—Section 1833(a)(1) of the 14
103	103	Social Security Act (42 U.S.C. 1395l(a)(1)) is 15
104	104	amended— 16
105	105	(A) by striking ‘‘and’’ before ‘‘(GG)’’; and 17
106	106	(B) by inserting before the semicolon at 18
107	107	the end the following: ‘‘, and (HH) with respect 19
108	108	to dental and oral health services (as defined in 20
109	109	section 1861(lll)), the amount paid shall be the 21
110	110	payment amount specified under section 22
111	111	1834(aa)’’. 23
112	112	(2) P
113	113	AYMENT AND LIMITS SPECIFIED .—Section 24
114	114	1834 of the Social Security Act (42 U.S.C. 1395m) 25
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118	118	is amended by adding at the end the following new 1
119	119	subsection: 2
120	120	‘‘(aa) P
121	121	AYMENT ANDLIMITS FORDENTAL ANDORAL 3
122	122	H
123	123	EALTHSERVICES.— 4
124	124	‘‘(1) I
125	125	N GENERAL.—The payment amount 5
126	126	under this part for dental and oral health services 6
127	127	(as defined in section 1861(nnn)) shall be, subject to 7
128	128	paragraph (3), the applicable percent (specified in 8
129	129	paragraph (2)) of the lesser of the actual charge for 9
130	130	the services or the amount determined under the 10
131	131	payment basis determined under section 1848. 11
132	132	‘‘(2) A
133	133	PPLICABLE PERCENT.— 12
134	134	‘‘(A) I
135	135	N GENERAL.—For purposes of para-13
136	136	graph (1), except as provided in subparagraph 14
137	137	(B), the applicable percent specified in this 15
138	138	paragraph is— 16
139	139	‘‘(i) with respect to services described 17
140	140	in section 1861(nnn)(1) furnished during 18
141	141	2024 or a subsequent year, 100 percent; 19
142	142	and 20
143	143	‘‘(ii) with respect to services not de-21
144	144	scribed in clause (i)— 22
145	145	‘‘(I) for a year before 2025, 0 23
146	146	percent; 24
147	147	‘‘(II) for 2025, 30 percent; 25
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151	151	‘‘(III) for 2026, 60 percent; and 1
152	152	‘‘(IV) for 2027 and each subse-2
153	153	quent year, 80 percent. 3
154	154	‘‘(B) S
155	155	PECIAL RULE FOR CERTAIN LOW -IN-4
156	156	COME INDIVIDUALS.—For purposes of para-5
157	157	graph (1), the applicable percent specified in 6
158	158	this paragraph is, with respect to services fur-7
159	159	nished to an individual who is a subsidy eligible 8
160	160	individual (as defined in section 1860D– 9
161	161	14(a)(3)), or who would be a subsidy eligible in-10
162	162	dividual if the individual were enrolled in a pre-11
163	163	scription drug plan or MA–PD plan— 12
164	164	‘‘(i) with respect to services described 13
165	165	in section 1861(nnn)(1), for 2024 and 14
166	166	each subsequent year, 100 percent; and 15
167	167	‘‘(ii) with respect to services not de-16
168	168	scribed in clause (i), for 2025 and each 17
169	169	subsequent year, 80 percent. 18
170	170	‘‘(3) L
171	171	IMITATIONS AND SECRETARIAL AUTHOR -19
172	172	ITY.— 20
173	173	‘‘(A) F
174	174	REQUENCY.—With respect to dental 21
175	175	and oral health services that are— 22
176	176	‘‘(i) routine dental cleanings, payment 23
177	177	may be made under this part for only two 24
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181	181	such cleanings during a 12-month period; 1
182	182	and 2
183	183	‘‘(ii) routine exams, payment may be 3
184	184	made under this part for only two such 4
185	185	exams during a 12-month period. 5
186	186	‘‘(B) S
187	187	ECRETARIAL AUTHORITY .— 6
188	188	‘‘(i) A
189	189	UTHORITY TO APPLY ADDI -7
190	190	TIONAL LIMITATIONS.—The Secretary may 8
191	191	apply such other reasonable limitations on 9
192	192	the extent to which dental and oral services 10
193	193	are covered under this part, including 11
194	194	through application of a prior authoriza-12
195	195	tion requirement. 13
196	196	‘‘(ii) A
197	197	UTHORITY TO MODIFY COV -14
198	198	ERAGE.—Notwithstanding any other provi-15
199	199	sion of this title, if the Secretary deter-16
200	200	mines appropriate, the Secretary may mod-17
201	201	ify the coverage under this part of dental 18
202	202	and oral health services to the extent that 19
203	203	such modification is consistent with the 20
204	204	recommendations of the United States Pre-21
205	205	ventive Services Task Force. 22
206	206	‘‘(iii) A
207	207	UTHORITY TO WAIVE FRE -23
208	208	QUENCY LIMITATIONS .—Notwithstanding 24
209	209	subparagraph (A), the Secretary may 25
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213	213	waive any frequency limitation under such 1
214	214	subparagraph for an individual (or cat-2
215	215	egory of individuals) if determined appro-3
216	216	priate by the Secretary.’’. 4
217	217	(d) P
218	218	AYMENTUNDERPHYSICIANFEESCHEDULE.— 5
219	219	Section 1848(j)(3) of the Social Security Act (42 U.S.C. 6
220	220	1395w–4(j)(3)) is amended by inserting ‘‘(2)(KK),’’ be-7
221	221	fore ‘‘(3)’’. 8
222	222	(e) D
223	223	ENTURES.— 9
224	224	(1) I
225	225	N GENERAL.—Section 1861(s)(8) of the 10
226	226	Social Security Act (42 U.S.C. 1395x(s)(8)) is 11
227	227	amended— 12
228	228	(A) by striking ‘‘(other than dental)’’ and 13
229	229	inserting ‘‘(including dentures)’’; and 14
230	230	(B) by striking ‘‘internal body’’. 15
231	231	(2) S
232	232	PECIAL PAYMENT RULES .—Section 16
233	233	1834(a) of the Social Security Act (42 U.S.C. 17
234	234	1395m(a)) is amended by adding at the end the fol-18
235	235	lowing new paragraph: 19
236	236	‘‘(23) P
237	237	AYMENT AND LIMITS FOR DENTURES .— 20
238	238	‘‘(A) I
239	239	N GENERAL.—The payment amount 21
240	240	under this part for dentures shall be, subject to 22
241	241	subparagraph (C), the applicable percent (speci-23
242	242	fied in subparagraph (B)) of the amount other-24
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246	246	wise payable for such dentures under this sec-1
247	247	tion. 2
248	248	‘‘(B) A
249	249	PPLICABLE PERCENT .—For pur-3
250	250	poses of subparagraph (A), the applicable per-4
251	251	cent specified in this subparagraph is— 5
252	252	‘‘(i) for a year before 2025, 0 percent; 6
253	253	and 7
254	254	‘‘(ii) for 2025 and each subsequent 8
255	255	year, 80 percent. 9
256	256	‘‘(C) L
257	257	IMITATIONS AND SECRETARIAL AU -10
258	258	THORITY.— 11
259	259	‘‘(i) I
260	260	N GENERAL.—Payment may be 12
261	261	made under this part for an individual 13
262	262	for— 14
263	263	‘‘(I) not more than one full upper 15
264	264	and one full lower denture once every 16
265	265	five years; and 17
266	266	‘‘(II) not more than one partial 18
267	267	upper denture and one partial lower 19
268	268	denture once every five years. 20
269	269	‘‘(ii) S
270	270	ECRETARIAL AUTHORITY .— 21
271	271	‘‘(I) A
272	272	UTHORITY TO APPLY ADDI -22
273	273	TIONAL LIMITATIONS.—The Secretary 23
274	274	may apply such other reasonable limi-24
275	275	tations on the extent to which den-25
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279	279	tures are covered under this part, in-1
280	280	cluding through application of a prior 2
281	281	authorization requirement. 3
282	282	‘‘(II) A
283	283	UTHORITY TO MODIFY 4
284	284	COVERAGE.—Notwithstanding any 5
285	285	other provision of this title, if the Sec-6
286	286	retary determines appropriate, the 7
287	287	Secretary may modify the coverage 8
288	288	under this part of dentures to the ex-9
289	289	tent that such modification is con-10
290	290	sistent with the recommendations of 11
291	291	the United States Preventive Services 12
292	292	Task Force. 13
293	293	‘‘(III) A
294	294	UTHORITY TO WAIVE 14
295	295	FREQUENCY LIMITATIONS .—Notwith-15
296	296	standing clause (i), the Secretary may 16
297	297	waive any frequency limitation under 17
298	298	such clause for an individual (or cat-18
299	299	egory of individuals) if determined ap-19
300	300	propriate by the Secretary.’’. 20
301	301	(f) R
302	302	EPEAL OFGROUND FOREXCLUSION.—Section 21
303	303	1862(a) of the Social Security Act (42 U.S.C. 1395y) is 22
304	304	amended by striking paragraph (12). 23
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308	308	(g) EFFECTIVEDATE.—The amendments made by 1
309	309	this section shall apply to services furnished on or after 2
310	310	January 1, 2024. 3
311	311	SEC. 3. VISION CARE. 4
312	312	(a) C
313	313	OVERAGE.—Section 1861(s)(2) of the Social Se-5
314	314	curity Act (42 U.S.C. 1395x(s)(2)), as amended by section 6
315	315	2, is further amended— 7
316	316	(1) in subparagraph (JJ), by striking ‘‘and’’ 8
317	317	after the semicolon at the end; 9
318	318	(2) in subparagraph (KK), by adding ‘‘and’’ 10
319	319	after the semicolon at the end; and 11
320	320	(3) by adding at the end the following new sub-12
321	321	paragraph: 13
322	322	‘‘(LL) vision services (as defined in subsection 14
323	323	(ooo));’’. 15
324	324	(b) V
325	325	ISIONSERVICESDEFINED.—Section 1861 of 16
326	326	the Social Security Act (42 U.S.C. 1395x), as amended 17
327	327	by section 2, is further amended by adding at the end the 18
328	328	following new subsection: 19
329	329	‘‘Vision Services 20
330	330	‘‘(ooo) The term ‘vision services’ means— 21
331	331	‘‘(1) routine eye examinations and procedures 22
332	332	performed (during the course of any eye examina-23
333	333	tion) to determine the refractive state of the eyes; 24
334	334	and 25
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338	338	‘‘(2) other necessary services related to eye and 1
339	339	vision health (as defined by the Secretary).’’. 2
340	340	(c) P
341	341	AYMENT; COINSURANCE; ANDLIMITATIONS.— 3
342	342	(1) I
343	343	N GENERAL.—Section 1833(a)(1) of the 4
344	344	Social Security Act (42 U.S.C. 1395l(a)(1)), as 5
345	345	amended by section 2, is further amended— 6
346	346	(A) by striking ‘‘and’’ before ‘‘(HH)’’; and 7
347	347	(B) by inserting before the semicolon at 8
348	348	the end the following: ‘‘, and (II) with respect 9
349	349	to vision services (as defined in section 10
350	350	1861(mmm)), the amount paid shall be the 11
351	351	payment amount specified under section 12
352	352	1834(bb)’’. 13
353	353	(2) P
354	354	AYMENT AND LIMITS SPECIFIED .—Section 14
355	355	1834 of the Social Security Act (42 U.S.C. 1395m), 15
356	356	as amended by section 2, is further amended by add-16
357	357	ing at the end the following new subsection: 17
358	358	‘‘(bb) P
359	359	AYMENT AND LIMITS FORVISIONSERV-18
360	360	ICES.— 19
361	361	‘‘(1) I
362	362	N GENERAL.—The payment amount 20
363	363	under this part for vision services (as defined in sec-21
364	364	tion 1861(ooo)) shall be, subject to paragraph (2), 22
365	365	80 percent of the lesser of the actual charge for the 23
366	366	services or the amount determined under the pay-24
367	367	ment basis determined under section 1848. 25
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371	371	‘‘(2) LIMITATIONS AND SECRETARIAL AUTHOR -1
372	372	ITY.— 2
373	373	‘‘(A) F
374	374	REQUENCY.—With respect to rou-3
375	375	tine eye exams, payment may be made under 4
376	376	this part for only one such exam during a 12- 5
377	377	month period. 6
378	378	‘‘(B) S
379	379	ECRETARIAL AUTHORITY .— 7
380	380	‘‘(i) A
381	381	UTHORITY TO APPLY ADDI -8
382	382	TIONAL LIMITATIONS.—The Secretary may 9
383	383	apply other reasonable limitations on the 10
384	384	extent to which vision services are covered 11
385	385	under this part, including through applica-12
386	386	tion of a prior authorization requirement. 13
387	387	‘‘(ii) A
388	388	UTHORITY TO MODIFY COV -14
389	389	ERAGE.—Notwithstanding any other provi-15
390	390	sion of this title, if the Secretary deter-16
391	391	mines appropriate, the Secretary may mod-17
392	392	ify the coverage under this part of vision 18
393	393	services to the extent that such modifica-19
394	394	tion is consistent with the recommenda-20
395	395	tions of the United States Preventive Serv-21
396	396	ices Task Force. 22
397	397	‘‘(iii) A
398	398	UTHORITY TO WAIVE FRE -23
399	399	QUENCY LIMITATIONS .—Notwithstanding 24
400	400	subparagraph (A), the Secretary may 25
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404	404	waive any frequency limitation under such 1
405	405	subparagraph for an individual (or cat-2
406	406	egory of individuals) if determined appro-3
407	407	priate by the Secretary.’’. 4
408	408	(d) P
409	409	AYMENTUNDERPHYSICIANFEESCHEDULE.— 5
410	410	Section 1848(j)(3) of the Social Security Act (42 U.S.C. 6
411	411	1395w–4(j)(3)) is amended by inserting ‘‘(2)(LL),’’ after 7
412	412	‘‘(2)(KK),’’ (as added by section 2). 8
413	413	(e) S
414	414	PECIALPAYMENTRULES FOREYEGLASSES, 9
415	415	C
416	416	ONTACTLENSES, ANDLOWVISIONDEVICES.—Section 10
417	417	1834(a) of the Social Security Act (42 U.S.C. 1395m(a)), 11
418	418	as amended by section 2, is further amended by adding 12
419	419	at the end the following: 13
420	420	‘‘(24) P
421	421	AYMENT AND LIMITS FOR EYEGLASSES 14
422	422	AND CONTACT LENSES .— 15
423	423	‘‘(A) I
424	424	N GENERAL.—The payment amount 16
425	425	under this part for eyeglass lenses, eyeglass 17
426	426	frames, and contact lenses shall be, subject to 18
427	427	subparagraph (B), 80 percent of the amount 19
428	428	otherwise payable for such eyeglass lenses, eye-20
429	429	glass frames, and contact lenses, respectively, 21
430	430	under this section. 22
431	431	‘‘(B) L
432	432	IMITATIONS AND SECRETARIAL AU -23
433	433	THORITY.— 24
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437	437	‘‘(i) IN GENERAL.—Subject to clause 1
438	438	(iii), payment may be made under this part 2
439	439	(other than for eyewear described in sec-3
440	440	tion 1861(s)(8)) for an individual for— 4
441	441	‘‘(I) not more than one pair of 5
442	442	eyeglass lenses during any 12-month 6
443	443	period in an amount not exceeding 7
444	444	$100; 8
445	445	‘‘(II) not more than one set of 9
446	446	eyeglass frames during any 24-month 10
447	447	period in an amount not exceeding 11
448	448	$100; and 12
449	449	‘‘(III) contact lenses, only to the 13
450	450	extent that the sum of such payments 14
451	451	for contact lenses does not exceed a 15
452	452	limitation of $200 during any 24- 16
453	453	month period beginning during the 17
454	454	first year beginning at least six 18
455	455	months after the date of the enact-19
456	456	ment of this paragraph (or, beginning 20
457	457	during a subsequent year, such limita-21
458	458	tion for a 24-month period beginning 22
459	459	in the previous year increase by an 23
460	460	appropriate inflation adjustment spec-24
461	461	ified by the Secretary). 25
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464	464	•HR 33 IH
465	465	‘‘(ii) SECRETARIAL AUTHORITY .— 1
466	466	‘‘(I) A
467	467	UTHORITY TO APPLY ADDI -2
468	468	TIONAL LIMITATIONS.—The Secretary 3
469	469	may apply such other reasonable limi-4
470	470	tations on the extent to which eye-5
471	471	glass lenses, eyeglass frames, and con-6
472	472	tact lenses are covered under this 7
473	473	part, including through application of 8
474	474	a prior authorization requirement. 9
475	475	‘‘(II) A
476	476	UTHORITY TO MODIFY 10
477	477	COVERAGE.—Notwithstanding any 11
478	478	other provision of this title, if the Sec-12
479	479	retary determines appropriate, the 13
480	480	Secretary may modify the coverage 14
481	481	under this part of eyeglass lenses, eye-15
482	482	glass frames, and contact lenses to 16
483	483	the extent that such modification is 17
484	484	consistent with the recommendations 18
485	485	of the United States Preventive Serv-19
486	486	ices Task Force. 20
487	487	‘‘(III) A
488	488	UTHORITY TO WAIVE 21
489	489	FREQUENCY LIMITATIONS .—Notwith-22
490	490	standing clause (i), the Secretary may 23
491	491	waive any frequency limitation under 24
492	492	such clause for an individual (or cat-25
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495	495	•HR 33 IH
496	496	egory of individuals) if determined ap-1
497	497	propriate by the Secretary. 2
498	498	‘‘(iii) U
499	499	PDATE OF PAYMENT LIMITS 3
500	500	TO ACCOUNT FOR INFLATION .—With re-4
501	501	spect to eyeglass lenses and contact lenses 5
502	502	furnished during 2025 or a subsequent 6
503	503	year, the Secretary shall increase the dollar 7
504	504	amounts in effect under this subparagraph 8
505	505	for such year by the percentage change in 9
506	506	the consumer price index for all urban con-10
507	507	sumers (United States city average) for 11
508	508	the 12-month period ending with June of 12
509	509	the previous year. 13
510	510	‘‘(25) P
511	511	AYMENT AND LIMITS FOR LOW VISION 14
512	512	DEVICES.— 15
513	513	‘‘(A) I
514	514	N GENERAL.—The payment amount 16
515	515	under this part for low vision devices shall be 17
516	516	80 percent of the amount otherwise payable for 18
517	517	low vision devices under this section. 19
518	518	‘‘(B) S
519	519	ECRETARIAL AUTHORITY .— 20
520	520	‘‘(i) A
521	521	UTHORITY TO APPLY LIMITA -21
522	522	TIONS.—The Secretary may apply reason-22
523	523	able limitations on the extent to which low 23
524	524	vision devices are covered under this part, 24
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527	527	•HR 33 IH
528	528	including through application of a prior 1
529	529	authorization requirement. 2
530	530	‘‘(ii) A
531	531	UTHORITY TO MODIFY COV -3
532	532	ERAGE.—Notwithstanding any other provi-4
533	533	sion of this title, if the Secretary deter-5
534	534	mines appropriate, the Secretary may mod-6
535	535	ify the coverage under this part of low vi-7
536	536	sion devices to the extent that such modi-8
537	537	fication is consistent with the recommenda-9
538	538	tions of the United States Preventive Serv-10
539	539	ices Task Force. 11
540	540	‘‘(C) L
541	541	OW VISION DEVICE DEFINED .—In 12
542	542	this paragraph, the term ‘low vision device’ 13
543	543	means a device, prescribed by a physician, that 14
544	544	magnifies, enhances, or otherwise augments or 15
545	545	interprets visual images irrespective of the size, 16
546	546	form, or technological features of such device 17
547	547	and does not include ordinary eyeglasses or con-18
548	548	tact lenses. In the previous sentence, the term 19
549	549	‘ordinary eyeglasses or contact lenses’ means 20
550	550	lenses that are intended to fully correct visual 21
551	551	acuity or fully eliminate refractive error.’’. 22
552	552	(f) D
553	553	EFINITION OFDURABLEMEDICALEQUIPMENT 23
554	554	T
555	555	OINCLUDEEYEGLASSES, CONTACTLENSES, ANDLOW 24
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558	558	•HR 33 IH
559	559	VISIONDEVICES.—Section 1861(n) of the Social Security 1
560	560	Act (42 U.S.C. 1395x(n)) is amended— 2
561	561	(1) by striking ‘‘and’’ before ‘‘eye tracking’’ and 3
562	562	inserting a comma; and 4
563	563	(2) by inserting ‘‘, and eyeglass lenses, low vi-5
564	564	sion devices (as defined in section 1834(a)(25)), eye-6
565	565	glass frames, and contact lenses’’ before ‘‘; except’’. 7
566	566	(g) R
567	567	EPEAL OFGROUND FOREXCLUSION.—Section 8
568	568	1862(a)(7) of the Social Security Act (42 U.S.C. 9
569	569	1395y(a)(7)) is amended by striking ‘‘, eyeglasses (other 10
570	570	than eyewear described in section 1861(s)(8)) or eye ex-11
571	571	aminations for the purpose of prescribing, fitting, or 12
572	572	changing eyeglasses, procedures performed (during the 13
573	573	course of any eye examination) to determine the refractive 14
574	574	state of the eyes’’. 15
575	575	(h) E
576	576	FFECTIVEDATE.—The amendments made by 16
577	577	this section shall apply to services furnished on or after 17
578	578	January 1, 2024. 18
579	579	SEC. 4. HEARING CARE. 19
580	580	(a) C
581	581	OVERAGE.— 20
582	582	(1) I
583	583	N GENERAL.—Section 1861(s)(2) of the 21
584	584	Social Security Act (42 U.S.C. 1395x(s)(2)), as 22
585	585	amended by sections 2 and 3, is further amended— 23
586	586	(A) in subparagraph (KK), by striking 24
587	587	‘‘and’’ at the end; 25
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590	590	•HR 33 IH
591	591	(B) in subparagraph (LL), by inserting 1
592	592	‘‘and’’ at the end; and 2
593	593	(C) by adding at the end the following new 3
594	594	subparagraph: 4
595	595	‘‘(MM) audiology services (as defined in sub-5
596	596	section (ll)(3)) and hearing services (as defined in 6
597	597	subsection (ll)(5));’’. 7
598	598	(2) H
599	599	EARING SERVICES DEFINED .—Section 8
600	600	1861(ll) of the Social Security Act (42 U.S.C. 9
601	601	1395x(ll)) is amended— 10
602	602	(A) in the subsection heading, by inserting 11
603	603	‘‘; H
604	604	EARINGSERVICES’’ after ‘‘AUDIOLOGY 12
605	605	S
606	606	ERVICES’’; and 13
607	607	(B) by adding at the end the following new 14
608	608	paragraph: 15
609	609	‘‘(5) The term ‘hearing services’ means— 16
610	610	‘‘(A) routine hearing exams and exams for 17
611	611	hearing aids; and 18
612	612	‘‘(B) other necessary services related to hearing 19
613	613	health (as defined by the Secretary).’’. 20
614	614	(b) P
615	615	AYMENT; COINSURANCE; ANDLIMITATIONS.— 21
616	616	(1) I
617	617	N GENERAL.—Section 1833(a)(1) of the 22
618	618	Social Security Act (42 U.S.C. 1395l(a)(1)), as 23
619	619	amended by sections 2 and 3, is further amended— 24
620	620	(A) by striking ‘‘and’’ before ‘‘(II)’’; and 25
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623	623	•HR 33 IH
624	624	(B) by inserting before the semicolon at 1
625	625	the end the following: ‘‘, and (JJ) with respect 2
626	626	to audiology services (as defined in section 3
627	627	1861(ll)(3)) and hearing services (as defined in 4
628	628	section 1861(ll)(5)), the amount paid shall be 5
629	629	the payment amount specified under section 6
630	630	1834(cc)’’. 7
631	631	(2) P
632	632	AYMENT AND LIMITS SPECIFIED .—Section 8
633	633	1834 of the Social Security Act (42 U.S.C. 1395m), 9
634	634	as amended by sections 2 and 3, is further amended 10
635	635	by adding at the end the following new subsection: 11
636	636	‘‘(cc) P
637	637	AYMENT AND LIMITS FORHEARINGSERV-12
638	638	ICES.— 13
639	639	‘‘(1) I
640	640	N GENERAL.—The payment amount 14
641	641	under this part for audiology services (as defined in 15
642	642	section 1861(ll)(3)) and hearing services (as defined 16
643	643	in section 1861(ll)(5)), shall be, subject to para-17
644	644	graph (2), 80 percent of the lesser of the actual 18
645	645	charge for the services or the amount determined 19
646	646	under the payment basis determined under section 20
647	647	1848. 21
648	648	‘‘(2) S
649	649	ECRETARIAL AUTHORITY .— 22
650	650	‘‘(A) A
651	651	UTHORITY TO APPLY LIMITA -23
652	652	TIONS.—The Secretary may apply reasonable 24
653	653	limitations on the extent to which audiology 25
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656	656	•HR 33 IH
657	657	services and hearing services are covered under 1
658	658	this part, including through application of a 2
659	659	prior authorization requirement. 3
660	660	‘‘(B) A
661	661	UTHORITY TO MODIFY COVERAGE .— 4
662	662	Notwithstanding any other provision of this 5
663	663	title, if the Secretary determines appropriate, 6
664	664	the Secretary may modify the coverage under 7
665	665	this part of audiology services and hearing serv-8
666	666	ices to the extent that such modification is con-9
667	667	sistent with the recommendations of the United 10
668	668	States Preventive Services Task Force.’’. 11
669	669	(c) P
670	670	AYMENTUNDER THEPHYSICIANFEESCHED-12
671	671	ULE.—Section 1848(j)(3) of the Social Security Act (42 13
672	672	U.S.C. 1395w–4(j)(3)), as amended by section 2(d), is 14
673	673	further amended by inserting ‘‘(2)(MM),’’ before ‘‘(3)’’. 15
674	674	(d) H
675	675	EARINGAIDS.— 16
676	676	(1) R
677	677	EPEAL OF GROUND FOR EXCLUSION .— 17
678	678	Section 1862(a)(7) of the Social Security Act (42 18
679	679	U.S.C. 1395y(a)(7)), as amended by section 3(g), is 19
680	680	further amended by striking ‘‘, hearing aids or ex-20
681	681	aminations therefor,’’. 21
682	682	(2) D
683	683	EFINITION OF DURABLE MEDICAL EQUIP -22
684	684	MENT TO INCLUDE HEARING AIDS .—Section 1861(n) 23
685	685	of the Social Security Act (42 U.S.C. 1395x(n)), as 24
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688	688	•HR 33 IH
689	689	amended by section 3, is further amended by insert-1
690	690	ing ‘‘hearing aids,’’ before ‘‘and eyeglass lenses’’. 2
691	691	(3) S
692	692	PECIAL PAYMENT RULES FOR HEARING 3
693	693	AIDS.—Section 1834(a) of the Social Security Act 4
694	694	(42 U.S.C. 1395m(a)), as amended by sections 2 5
695	695	and 3, is further amended by adding at the end the 6
696	696	following new paragraph: 7
697	697	‘‘(26) P
698	698	AYMENT AND LIMITS FOR HEARING 8
699	699	AIDS.— 9
700	700	‘‘(A) I
701	701	N GENERAL.—The payment amount 10
702	702	under this part for hearing aids shall be, sub-11
703	703	ject to subparagraph (B), 80 percent of the 12
704	704	amount otherwise payable for hearing aids 13
705	705	under this section. 14
706	706	‘‘(B) L
707	707	IMITATIONS AND SECRETARIAL AU -15
708	708	THORITY.— 16
709	709	‘‘(i) I
710	710	N GENERAL.—Payment may be 17
711	711	made under this part for an individual for 18
712	712	not more than one hearing aid per ear dur-19
713	713	ing a 48-month period. 20
714	714	‘‘(ii) S
715	715	ECRETARIAL AUTHORITY .— 21
716	716	‘‘(I) A
717	717	UTHORITY TO APPLY ADDI -22
718	718	TIONAL LIMITATIONS.—The Secretary 23
719	719	may apply additional limitations on 24
720	720	the extent to which hearing aids are 25
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723	723	•HR 33 IH
724	724	covered under this part, including 1
725	725	through application of a prior author-2
726	726	ization requirement and through ap-3
727	727	plication of criteria for a minimum 4
728	728	level of hearing loss for coverage of an 5
729	729	initial or replacement hearing aid. 6
730	730	‘‘(II) A
731	731	UTHORITY TO MODIFY 7
732	732	COVERAGE.—Notwithstanding any 8
733	733	other provision of this title, if the Sec-9
734	734	retary determines appropriate, the 10
735	735	Secretary may modify the coverage 11
736	736	under this part of hearing aids to the 12
737	737	extent that such modification is con-13
738	738	sistent with the recommendations of 14
739	739	the United States Preventive Services 15
740	740	Task Force. 16
741	741	‘‘(iii) A
742	742	UTHORITY TO WAIVE FRE -17
743	743	QUENCY LIMITATIONS .—Notwithstanding 18
744	744	clause (i), the Secretary may waive any 19
745	745	frequency limitation under such clause for 20
746	746	an individual (or category of individuals) if 21
747	747	determined appropriate by the Secretary.’’. 22
748	748	(e) E
749	749	FFECTIVEDATE.—The amendments made by 23
750	750	this section shall apply to services furnished on or after 24
751	751	January 1, 2024. 25
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754	754	•HR 33 IH
755	755	SEC. 5. NONAPPLICATION OF COMPETITIVE ACQUISITION 1
756	756	TO CERTAIN ITEMS. 2
757	757	Section 1847(a)(2) of the Social Security Act (42 3
758	758	U.S.C. 1395w–3(a)(2)) is amended— 4
759	759	(1) by striking ‘‘and excluding’’ and inserting 5
760	760	‘‘excluding’’; and 6
761	761	(2) by inserting ‘‘, and excluding dentures, eye-7
762	762	glass lenses, contact lenses, and hearing aids’’ before 8
763	763	the period at the end. 9
764	764	SEC. 6. INCLUSION OF AN ORAL HEALTH PROFESSIONAL 10
765	765	ON THE UNITED STATES PREVENTIVE SERV-11
766	766	ICES TASK FORCE. 12
767	767	(a) I
768	768	NGENERAL.—The first sentence of section 13
769	769	915(a)(1) of the Public Health Service Act (42 U.S.C. 14
770	770	299b–4(a)(1)) is amended by inserting ‘‘, including at 15
771	771	least 1 oral health professional’’ before the period at the 16
772	772	end. 17
773	773	(b) E
774	774	FFECTIVEDATE.—The amendment made by 18
775	775	subsection (a) shall apply beginning on January 1 of the 19
776	776	first year beginning at least 6 months after the date of 20
777	777	the enactment of this Act. 21
778	778	Æ
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