I
118THCONGRESS
1
STSESSION H. R. 33
To amend title XVIII of the Social Security Act to provide for coverage
of dental, vision, and hearing care under the Medicare program.
IN THE HOUSE OF REPRESENTATIVES
JANUARY9, 2023
Mr. D
OGGETT(for himself, Mrs. BEATTY, Mr. BEYER, Mr. BISHOPof Geor-
gia, Mr. B
LUMENAUER, Mr. BOWMAN, Ms. BUSH, Mr. CARSON, Mr. CAR-
TERof Louisiana, Mr. CARTWRIGHT, Mr. CASAR, Mr. CASTROof Texas,
Ms. C
HU, Mr. CLEAVER, Mr. COHEN, Mr. CONNOLLY, Mr. COURTNEY,
Mr. C
UELLAR, Ms. DELAURO, Mr. DESAULNIER, Mrs. DINGELL, Ms.
E
SCOBAR, Mr. ESPAILLAT, Mr. EVANS, Ms. LEGERFERNANDEZ, Mr.
G
ARAMENDI, Mr. GARCI´Aof Illinois, Ms. GARCIAof Texas, Mr. VICENTE
G
ONZALEZof Texas, Mr. GOTTHEIMER, Mr. GREENof Texas, Mr. GRI-
JALVA, Mrs. HAYES, Mr. HIGGINSof New York, Ms. JACKSONLEE, Ms.
J
AYAPAL, Mr. JOHNSONof Georgia, Ms. KAPTUR, Mr. KHANNA, Mr. KIM
of New Jersey, Mr. L
ARSONof Connecticut, Ms. LEEof California, Mr.
L
IEU, Ms. MCCOLLUM, Mr. MCGOVERN, Ms. MENG, Mr. MFUME, Ms.
M
OOREof Wisconsin, Mr. NADLER, Mr. NEGUSE, Mr. NORCROSS, Ms.
N
ORTON, Ms. OCASIO-CORTEZ, Ms. OMAR, Mr. PASCRELL, Mr. PAYNE,
Ms. P
INGREE, Mr. POCAN, Ms. PORTER, Ms. PRESSLEY, Ms. BLUNT
R
OCHESTER, Mr. RUIZ, Mr. RUPPERSBERGER, Ms. SCHAKOWSKY, Mr.
S
CHIFF, Mr. DAVIDSCOTTof Georgia, Mr. SHERMAN, Mr. SWALWELL,
Mr. T
AKANO, Mr. THOMPSONof California, Ms. TITUS, Ms. TLAIB, Mr.
T
ONKO, Mr. TORRESof New York, Mrs. TRAHAN, Mr. TRONE, Mr.
V
EASEY, Mrs. WATSONCOLEMAN, and Ms. WILLIAMSof Georgia) intro-
duced the following bill; which was referred to the Committee on Energy
and Commerce, and in addition to the Committee on Ways and Means,
for a period to be subsequently determined by the Speaker, in each case
for consideration of such provisions as fall within the jurisdiction of the
committee concerned
A BILL
To amend title XVIII of the Social Security Act to provide
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 2
•HR 33 IH
for coverage of dental, vision, and hearing care 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. SHORT TITLE. 3
This Act may be cited as the ‘‘Medicare Dental, Vi-4
sion, and Hearing Benefit Act of 2023’’. 5
SEC. 2. DENTAL AND ORAL HEALTH CARE. 6
(a) C
OVERAGE.—Section 1861(s)(2) of the Social Se-7
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 8
(1) in subparagraph (II), by striking ‘‘and’’ 9
after the semicolon at the end; 10
(2) in subparagraph (JJ), by adding ‘‘and’’ 11
after the semicolon at the end; and 12
(3) by adding at the end the following new sub-13
paragraph: 14
‘‘(KK) dental and oral health services (as de-15
fined in subsection (nnn));’’. 16
(b) D
ENTAL AND ORALHEALTHSERVICESDE-17
FINED.—Section 1861 of the Social Security Act (42 18
U.S.C. 1395x) is amended by adding at the end the fol-19
lowing new subsection: 20
‘‘Dental and Oral Health Services 21
‘‘(nnn) The term ‘dental and oral health services’ 22
means— 23
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 3
•HR 33 IH
‘‘(1) preventative and screening services, such 1
as oral exams, dental cleanings, dental x-rays, and 2
fluoride treatments; 3
‘‘(2) basic dental services, such as tooth res-4
torations, basic periodontics services, tooth extrac-5
tions, and oral disease management services; 6
‘‘(3) major dental services, such as major tooth 7
restorations, major periodontics services, bridges, 8
crowns, root canals, and extractions; 9
‘‘(4) emergency dental care; and 10
‘‘(5) other necessary services related to dental 11
or oral health (as defined by the Secretary).’’. 12
(c) P
AYMENT; COINSURANCE; ANDLIMITATIONS.— 13
(1) I
N GENERAL.—Section 1833(a)(1) of the 14
Social Security Act (42 U.S.C. 1395l(a)(1)) is 15
amended— 16
(A) by striking ‘‘and’’ before ‘‘(GG)’’; and 17
(B) by inserting before the semicolon at 18
the end the following: ‘‘, and (HH) with respect 19
to dental and oral health services (as defined in 20
section 1861(lll)), the amount paid shall be the 21
payment amount specified under section 22
1834(aa)’’. 23
(2) P
AYMENT AND LIMITS SPECIFIED .—Section 24
1834 of the Social Security Act (42 U.S.C. 1395m) 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 4
•HR 33 IH
is amended by adding at the end the following new 1
subsection: 2
‘‘(aa) P
AYMENT ANDLIMITS FORDENTAL ANDORAL 3
H
EALTHSERVICES.— 4
‘‘(1) I
N GENERAL.—The payment amount 5
under this part for dental and oral health services 6
(as defined in section 1861(nnn)) shall be, subject to 7
paragraph (3), the applicable percent (specified in 8
paragraph (2)) of the lesser of the actual charge for 9
the services or the amount determined under the 10
payment basis determined under section 1848. 11
‘‘(2) A
PPLICABLE PERCENT.— 12
‘‘(A) I
N GENERAL.—For purposes of para-13
graph (1), except as provided in subparagraph 14
(B), the applicable percent specified in this 15
paragraph is— 16
‘‘(i) with respect to services described 17
in section 1861(nnn)(1) furnished during 18
2024 or a subsequent year, 100 percent; 19
and 20
‘‘(ii) with respect to services not de-21
scribed in clause (i)— 22
‘‘(I) for a year before 2025, 0 23
percent; 24
‘‘(II) for 2025, 30 percent; 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 5
•HR 33 IH
‘‘(III) for 2026, 60 percent; and 1
‘‘(IV) for 2027 and each subse-2
quent year, 80 percent. 3
‘‘(B) S
PECIAL RULE FOR CERTAIN LOW -IN-4
COME INDIVIDUALS.—For purposes of para-5
graph (1), the applicable percent specified in 6
this paragraph is, with respect to services fur-7
nished to an individual who is a subsidy eligible 8
individual (as defined in section 1860D– 9
14(a)(3)), or who would be a subsidy eligible in-10
dividual if the individual were enrolled in a pre-11
scription drug plan or MA–PD plan— 12
‘‘(i) with respect to services described 13
in section 1861(nnn)(1), for 2024 and 14
each subsequent year, 100 percent; and 15
‘‘(ii) with respect to services not de-16
scribed in clause (i), for 2025 and each 17
subsequent year, 80 percent. 18
‘‘(3) L
IMITATIONS AND SECRETARIAL AUTHOR -19
ITY.— 20
‘‘(A) F
REQUENCY.—With respect to dental 21
and oral health services that are— 22
‘‘(i) routine dental cleanings, payment 23
may be made under this part for only two 24
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 6
•HR 33 IH
such cleanings during a 12-month period; 1
and 2
‘‘(ii) routine exams, payment may be 3
made under this part for only two such 4
exams during a 12-month period. 5
‘‘(B) S
ECRETARIAL AUTHORITY .— 6
‘‘(i) A
UTHORITY TO APPLY ADDI -7
TIONAL LIMITATIONS.—The Secretary may 8
apply such other reasonable limitations on 9
the extent to which dental and oral services 10
are covered under this part, including 11
through application of a prior authoriza-12
tion requirement. 13
‘‘(ii) A
UTHORITY TO MODIFY COV -14
ERAGE.—Notwithstanding any other provi-15
sion of this title, if the Secretary deter-16
mines appropriate, the Secretary may mod-17
ify the coverage under this part of dental 18
and oral health services to the extent that 19
such modification is consistent with the 20
recommendations of the United States Pre-21
ventive Services Task Force. 22
‘‘(iii) A
UTHORITY TO WAIVE FRE -23
QUENCY LIMITATIONS .—Notwithstanding 24
subparagraph (A), the Secretary may 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 7
•HR 33 IH
waive any frequency limitation under such 1
subparagraph for an individual (or cat-2
egory of individuals) if determined appro-3
priate by the Secretary.’’. 4
(d) P
AYMENTUNDERPHYSICIANFEESCHEDULE.— 5
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 6
1395w–4(j)(3)) is amended by inserting ‘‘(2)(KK),’’ be-7
fore ‘‘(3)’’. 8
(e) D
ENTURES.— 9
(1) I
N GENERAL.—Section 1861(s)(8) of the 10
Social Security Act (42 U.S.C. 1395x(s)(8)) is 11
amended— 12
(A) by striking ‘‘(other than dental)’’ and 13
inserting ‘‘(including dentures)’’; and 14
(B) by striking ‘‘internal body’’. 15
(2) S
PECIAL PAYMENT RULES .—Section 16
1834(a) of the Social Security Act (42 U.S.C. 17
1395m(a)) is amended by adding at the end the fol-18
lowing new paragraph: 19
‘‘(23) P
AYMENT AND LIMITS FOR DENTURES .— 20
‘‘(A) I
N GENERAL.—The payment amount 21
under this part for dentures shall be, subject to 22
subparagraph (C), the applicable percent (speci-23
fied in subparagraph (B)) of the amount other-24
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 8
•HR 33 IH
wise payable for such dentures under this sec-1
tion. 2
‘‘(B) A
PPLICABLE PERCENT .—For pur-3
poses of subparagraph (A), the applicable per-4
cent specified in this subparagraph is— 5
‘‘(i) for a year before 2025, 0 percent; 6
and 7
‘‘(ii) for 2025 and each subsequent 8
year, 80 percent. 9
‘‘(C) L
IMITATIONS AND SECRETARIAL AU -10
THORITY.— 11
‘‘(i) I
N GENERAL.—Payment may be 12
made under this part for an individual 13
for— 14
‘‘(I) not more than one full upper 15
and one full lower denture once every 16
five years; and 17
‘‘(II) not more than one partial 18
upper denture and one partial lower 19
denture once every five years. 20
‘‘(ii) S
ECRETARIAL AUTHORITY .— 21
‘‘(I) A
UTHORITY TO APPLY ADDI -22
TIONAL LIMITATIONS.—The Secretary 23
may apply such other reasonable limi-24
tations on the extent to which den-25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 9
•HR 33 IH
tures are covered under this part, in-1
cluding through application of a prior 2
authorization requirement. 3
‘‘(II) A
UTHORITY TO MODIFY 4
COVERAGE.—Notwithstanding any 5
other provision of this title, if the Sec-6
retary determines appropriate, the 7
Secretary may modify the coverage 8
under this part of dentures to the ex-9
tent that such modification is con-10
sistent with the recommendations of 11
the United States Preventive Services 12
Task Force. 13
‘‘(III) A
UTHORITY TO WAIVE 14
FREQUENCY LIMITATIONS .—Notwith-15
standing clause (i), the Secretary may 16
waive any frequency limitation under 17
such clause for an individual (or cat-18
egory of individuals) if determined ap-19
propriate by the Secretary.’’. 20
(f) R
EPEAL OFGROUND FOREXCLUSION.—Section 21
1862(a) of the Social Security Act (42 U.S.C. 1395y) is 22
amended by striking paragraph (12). 23
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 10
•HR 33 IH
(g) EFFECTIVEDATE.—The amendments made by 1
this section shall apply to services furnished on or after 2
January 1, 2024. 3
SEC. 3. VISION CARE. 4
(a) C
OVERAGE.—Section 1861(s)(2) of the Social Se-5
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section 6
2, is further amended— 7
(1) in subparagraph (JJ), by striking ‘‘and’’ 8
after the semicolon at the end; 9
(2) in subparagraph (KK), by adding ‘‘and’’ 10
after the semicolon at the end; and 11
(3) by adding at the end the following new sub-12
paragraph: 13
‘‘(LL) vision services (as defined in subsection 14
(ooo));’’. 15
(b) V
ISIONSERVICESDEFINED.—Section 1861 of 16
the Social Security Act (42 U.S.C. 1395x), as amended 17
by section 2, is further amended by adding at the end the 18
following new subsection: 19
‘‘Vision Services 20
‘‘(ooo) The term ‘vision services’ means— 21
‘‘(1) routine eye examinations and procedures 22
performed (during the course of any eye examina-23
tion) to determine the refractive state of the eyes; 24
and 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 11
•HR 33 IH
‘‘(2) other necessary services related to eye and 1
vision health (as defined by the Secretary).’’. 2
(c) P
AYMENT; COINSURANCE; ANDLIMITATIONS.— 3
(1) I
N GENERAL.—Section 1833(a)(1) of the 4
Social Security Act (42 U.S.C. 1395l(a)(1)), as 5
amended by section 2, is further amended— 6
(A) by striking ‘‘and’’ before ‘‘(HH)’’; and 7
(B) by inserting before the semicolon at 8
the end the following: ‘‘, and (II) with respect 9
to vision services (as defined in section 10
1861(mmm)), the amount paid shall be the 11
payment amount specified under section 12
1834(bb)’’. 13
(2) P
AYMENT AND LIMITS SPECIFIED .—Section 14
1834 of the Social Security Act (42 U.S.C. 1395m), 15
as amended by section 2, is further amended by add-16
ing at the end the following new subsection: 17
‘‘(bb) P
AYMENT AND LIMITS FORVISIONSERV-18
ICES.— 19
‘‘(1) I
N GENERAL.—The payment amount 20
under this part for vision services (as defined in sec-21
tion 1861(ooo)) shall be, subject to paragraph (2), 22
80 percent of the lesser of the actual charge for the 23
services or the amount determined under the pay-24
ment basis determined under section 1848. 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 12
•HR 33 IH
‘‘(2) LIMITATIONS AND SECRETARIAL AUTHOR -1
ITY.— 2
‘‘(A) F
REQUENCY.—With respect to rou-3
tine eye exams, payment may be made under 4
this part for only one such exam during a 12- 5
month period. 6
‘‘(B) S
ECRETARIAL AUTHORITY .— 7
‘‘(i) A
UTHORITY TO APPLY ADDI -8
TIONAL LIMITATIONS.—The Secretary may 9
apply other reasonable limitations on the 10
extent to which vision services are covered 11
under this part, including through applica-12
tion of a prior authorization requirement. 13
‘‘(ii) A
UTHORITY TO MODIFY COV -14
ERAGE.—Notwithstanding any other provi-15
sion of this title, if the Secretary deter-16
mines appropriate, the Secretary may mod-17
ify the coverage under this part of vision 18
services to the extent that such modifica-19
tion is consistent with the recommenda-20
tions of the United States Preventive Serv-21
ices Task Force. 22
‘‘(iii) A
UTHORITY TO WAIVE FRE -23
QUENCY LIMITATIONS .—Notwithstanding 24
subparagraph (A), the Secretary may 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 13
•HR 33 IH
waive any frequency limitation under such 1
subparagraph for an individual (or cat-2
egory of individuals) if determined appro-3
priate by the Secretary.’’. 4
(d) P
AYMENTUNDERPHYSICIANFEESCHEDULE.— 5
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 6
1395w–4(j)(3)) is amended by inserting ‘‘(2)(LL),’’ after 7
‘‘(2)(KK),’’ (as added by section 2). 8
(e) S
PECIALPAYMENTRULES FOREYEGLASSES, 9
C
ONTACTLENSES, ANDLOWVISIONDEVICES.—Section 10
1834(a) of the Social Security Act (42 U.S.C. 1395m(a)), 11
as amended by section 2, is further amended by adding 12
at the end the following: 13
‘‘(24) P
AYMENT AND LIMITS FOR EYEGLASSES 14
AND CONTACT LENSES .— 15
‘‘(A) I
N GENERAL.—The payment amount 16
under this part for eyeglass lenses, eyeglass 17
frames, and contact lenses shall be, subject to 18
subparagraph (B), 80 percent of the amount 19
otherwise payable for such eyeglass lenses, eye-20
glass frames, and contact lenses, respectively, 21
under this section. 22
‘‘(B) L
IMITATIONS AND SECRETARIAL AU -23
THORITY.— 24
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 14
•HR 33 IH
‘‘(i) IN GENERAL.—Subject to clause 1
(iii), payment may be made under this part 2
(other than for eyewear described in sec-3
tion 1861(s)(8)) for an individual for— 4
‘‘(I) not more than one pair of 5
eyeglass lenses during any 12-month 6
period in an amount not exceeding 7
$100; 8
‘‘(II) not more than one set of 9
eyeglass frames during any 24-month 10
period in an amount not exceeding 11
$100; and 12
‘‘(III) contact lenses, only to the 13
extent that the sum of such payments 14
for contact lenses does not exceed a 15
limitation of $200 during any 24- 16
month period beginning during the 17
first year beginning at least six 18
months after the date of the enact-19
ment of this paragraph (or, beginning 20
during a subsequent year, such limita-21
tion for a 24-month period beginning 22
in the previous year increase by an 23
appropriate inflation adjustment spec-24
ified by the Secretary). 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 15
•HR 33 IH
‘‘(ii) SECRETARIAL AUTHORITY .— 1
‘‘(I) A
UTHORITY TO APPLY ADDI -2
TIONAL LIMITATIONS.—The Secretary 3
may apply such other reasonable limi-4
tations on the extent to which eye-5
glass lenses, eyeglass frames, and con-6
tact lenses are covered under this 7
part, including through application of 8
a prior authorization requirement. 9
‘‘(II) A
UTHORITY TO MODIFY 10
COVERAGE.—Notwithstanding any 11
other provision of this title, if the Sec-12
retary determines appropriate, the 13
Secretary may modify the coverage 14
under this part of eyeglass lenses, eye-15
glass frames, and contact lenses to 16
the extent that such modification is 17
consistent with the recommendations 18
of the United States Preventive Serv-19
ices Task Force. 20
‘‘(III) A
UTHORITY TO WAIVE 21
FREQUENCY LIMITATIONS .—Notwith-22
standing clause (i), the Secretary may 23
waive any frequency limitation under 24
such clause for an individual (or cat-25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 16
•HR 33 IH
egory of individuals) if determined ap-1
propriate by the Secretary. 2
‘‘(iii) U
PDATE OF PAYMENT LIMITS 3
TO ACCOUNT FOR INFLATION .—With re-4
spect to eyeglass lenses and contact lenses 5
furnished during 2025 or a subsequent 6
year, the Secretary shall increase the dollar 7
amounts in effect under this subparagraph 8
for such year by the percentage change in 9
the consumer price index for all urban con-10
sumers (United States city average) for 11
the 12-month period ending with June of 12
the previous year. 13
‘‘(25) P
AYMENT AND LIMITS FOR LOW VISION 14
DEVICES.— 15
‘‘(A) I
N GENERAL.—The payment amount 16
under this part for low vision devices shall be 17
80 percent of the amount otherwise payable for 18
low vision devices under this section. 19
‘‘(B) S
ECRETARIAL AUTHORITY .— 20
‘‘(i) A
UTHORITY TO APPLY LIMITA -21
TIONS.—The Secretary may apply reason-22
able limitations on the extent to which low 23
vision devices are covered under this part, 24
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 17
•HR 33 IH
including through application of a prior 1
authorization requirement. 2
‘‘(ii) A
UTHORITY TO MODIFY COV -3
ERAGE.—Notwithstanding any other provi-4
sion of this title, if the Secretary deter-5
mines appropriate, the Secretary may mod-6
ify the coverage under this part of low vi-7
sion devices to the extent that such modi-8
fication is consistent with the recommenda-9
tions of the United States Preventive Serv-10
ices Task Force. 11
‘‘(C) L
OW VISION DEVICE DEFINED .—In 12
this paragraph, the term ‘low vision device’ 13
means a device, prescribed by a physician, that 14
magnifies, enhances, or otherwise augments or 15
interprets visual images irrespective of the size, 16
form, or technological features of such device 17
and does not include ordinary eyeglasses or con-18
tact lenses. In the previous sentence, the term 19
‘ordinary eyeglasses or contact lenses’ means 20
lenses that are intended to fully correct visual 21
acuity or fully eliminate refractive error.’’. 22
(f) D
EFINITION OFDURABLEMEDICALEQUIPMENT 23
T
OINCLUDEEYEGLASSES, CONTACTLENSES, ANDLOW 24
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 18
•HR 33 IH
VISIONDEVICES.—Section 1861(n) of the Social Security 1
Act (42 U.S.C. 1395x(n)) is amended— 2
(1) by striking ‘‘and’’ before ‘‘eye tracking’’ and 3
inserting a comma; and 4
(2) by inserting ‘‘, and eyeglass lenses, low vi-5
sion devices (as defined in section 1834(a)(25)), eye-6
glass frames, and contact lenses’’ before ‘‘; except’’. 7
(g) R
EPEAL OFGROUND FOREXCLUSION.—Section 8
1862(a)(7) of the Social Security Act (42 U.S.C. 9
1395y(a)(7)) is amended by striking ‘‘, eyeglasses (other 10
than eyewear described in section 1861(s)(8)) or eye ex-11
aminations for the purpose of prescribing, fitting, or 12
changing eyeglasses, procedures performed (during the 13
course of any eye examination) to determine the refractive 14
state of the eyes’’. 15
(h) E
FFECTIVEDATE.—The amendments made by 16
this section shall apply to services furnished on or after 17
January 1, 2024. 18
SEC. 4. HEARING CARE. 19
(a) C
OVERAGE.— 20
(1) I
N GENERAL.—Section 1861(s)(2) of the 21
Social Security Act (42 U.S.C. 1395x(s)(2)), as 22
amended by sections 2 and 3, is further amended— 23
(A) in subparagraph (KK), by striking 24
‘‘and’’ at the end; 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 19
•HR 33 IH
(B) in subparagraph (LL), by inserting 1
‘‘and’’ at the end; and 2
(C) by adding at the end the following new 3
subparagraph: 4
‘‘(MM) audiology services (as defined in sub-5
section (ll)(3)) and hearing services (as defined in 6
subsection (ll)(5));’’. 7
(2) H
EARING SERVICES DEFINED .—Section 8
1861(ll) of the Social Security Act (42 U.S.C. 9
1395x(ll)) is amended— 10
(A) in the subsection heading, by inserting 11
‘‘; H
EARINGSERVICES’’ after ‘‘AUDIOLOGY 12
S
ERVICES’’; and 13
(B) by adding at the end the following new 14
paragraph: 15
‘‘(5) The term ‘hearing services’ means— 16
‘‘(A) routine hearing exams and exams for 17
hearing aids; and 18
‘‘(B) other necessary services related to hearing 19
health (as defined by the Secretary).’’. 20
(b) P
AYMENT; COINSURANCE; ANDLIMITATIONS.— 21
(1) I
N GENERAL.—Section 1833(a)(1) of the 22
Social Security Act (42 U.S.C. 1395l(a)(1)), as 23
amended by sections 2 and 3, is further amended— 24
(A) by striking ‘‘and’’ before ‘‘(II)’’; and 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 20
•HR 33 IH
(B) by inserting before the semicolon at 1
the end the following: ‘‘, and (JJ) with respect 2
to audiology services (as defined in section 3
1861(ll)(3)) and hearing services (as defined in 4
section 1861(ll)(5)), the amount paid shall be 5
the payment amount specified under section 6
1834(cc)’’. 7
(2) P
AYMENT AND LIMITS SPECIFIED .—Section 8
1834 of the Social Security Act (42 U.S.C. 1395m), 9
as amended by sections 2 and 3, is further amended 10
by adding at the end the following new subsection: 11
‘‘(cc) P
AYMENT AND LIMITS FORHEARINGSERV-12
ICES.— 13
‘‘(1) I
N GENERAL.—The payment amount 14
under this part for audiology services (as defined in 15
section 1861(ll)(3)) and hearing services (as defined 16
in section 1861(ll)(5)), shall be, subject to para-17
graph (2), 80 percent of the lesser of the actual 18
charge for the services or the amount determined 19
under the payment basis determined under section 20
1848. 21
‘‘(2) S
ECRETARIAL AUTHORITY .— 22
‘‘(A) A
UTHORITY TO APPLY LIMITA -23
TIONS.—The Secretary may apply reasonable 24
limitations on the extent to which audiology 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 21
•HR 33 IH
services and hearing services are covered under 1
this part, including through application of a 2
prior authorization requirement. 3
‘‘(B) A
UTHORITY TO MODIFY COVERAGE .— 4
Notwithstanding any other provision of this 5
title, if the Secretary determines appropriate, 6
the Secretary may modify the coverage under 7
this part of audiology services and hearing serv-8
ices to the extent that such modification is con-9
sistent with the recommendations of the United 10
States Preventive Services Task Force.’’. 11
(c) P
AYMENTUNDER THEPHYSICIANFEESCHED-12
ULE.—Section 1848(j)(3) of the Social Security Act (42 13
U.S.C. 1395w–4(j)(3)), as amended by section 2(d), is 14
further amended by inserting ‘‘(2)(MM),’’ before ‘‘(3)’’. 15
(d) H
EARINGAIDS.— 16
(1) R
EPEAL OF GROUND FOR EXCLUSION .— 17
Section 1862(a)(7) of the Social Security Act (42 18
U.S.C. 1395y(a)(7)), as amended by section 3(g), is 19
further amended by striking ‘‘, hearing aids or ex-20
aminations therefor,’’. 21
(2) D
EFINITION OF DURABLE MEDICAL EQUIP -22
MENT TO INCLUDE HEARING AIDS .—Section 1861(n) 23
of the Social Security Act (42 U.S.C. 1395x(n)), as 24
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 22
•HR 33 IH
amended by section 3, is further amended by insert-1
ing ‘‘hearing aids,’’ before ‘‘and eyeglass lenses’’. 2
(3) S
PECIAL PAYMENT RULES FOR HEARING 3
AIDS.—Section 1834(a) of the Social Security Act 4
(42 U.S.C. 1395m(a)), as amended by sections 2 5
and 3, is further amended by adding at the end the 6
following new paragraph: 7
‘‘(26) P
AYMENT AND LIMITS FOR HEARING 8
AIDS.— 9
‘‘(A) I
N GENERAL.—The payment amount 10
under this part for hearing aids shall be, sub-11
ject to subparagraph (B), 80 percent of the 12
amount otherwise payable for hearing aids 13
under this section. 14
‘‘(B) L
IMITATIONS AND SECRETARIAL AU -15
THORITY.— 16
‘‘(i) I
N GENERAL.—Payment may be 17
made under this part for an individual for 18
not more than one hearing aid per ear dur-19
ing a 48-month period. 20
‘‘(ii) S
ECRETARIAL AUTHORITY .— 21
‘‘(I) A
UTHORITY TO APPLY ADDI -22
TIONAL LIMITATIONS.—The Secretary 23
may apply additional limitations on 24
the extent to which hearing aids are 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 23
•HR 33 IH
covered under this part, including 1
through application of a prior author-2
ization requirement and through ap-3
plication of criteria for a minimum 4
level of hearing loss for coverage of an 5
initial or replacement hearing aid. 6
‘‘(II) A
UTHORITY TO MODIFY 7
COVERAGE.—Notwithstanding any 8
other provision of this title, if the Sec-9
retary determines appropriate, the 10
Secretary may modify the coverage 11
under this part of hearing aids to the 12
extent that such modification is con-13
sistent with the recommendations of 14
the United States Preventive Services 15
Task Force. 16
‘‘(iii) A
UTHORITY TO WAIVE FRE -17
QUENCY LIMITATIONS .—Notwithstanding 18
clause (i), the Secretary may waive any 19
frequency limitation under such clause for 20
an individual (or category of individuals) if 21
determined appropriate by the Secretary.’’. 22
(e) E
FFECTIVEDATE.—The amendments made by 23
this section shall apply to services furnished on or after 24
January 1, 2024. 25
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS 24
•HR 33 IH
SEC. 5. NONAPPLICATION OF COMPETITIVE ACQUISITION 1
TO CERTAIN ITEMS. 2
Section 1847(a)(2) of the Social Security Act (42 3
U.S.C. 1395w–3(a)(2)) is amended— 4
(1) by striking ‘‘and excluding’’ and inserting 5
‘‘excluding’’; and 6
(2) by inserting ‘‘, and excluding dentures, eye-7
glass lenses, contact lenses, and hearing aids’’ before 8
the period at the end. 9
SEC. 6. INCLUSION OF AN ORAL HEALTH PROFESSIONAL 10
ON THE UNITED STATES PREVENTIVE SERV-11
ICES TASK FORCE. 12
(a) I
NGENERAL.—The first sentence of section 13
915(a)(1) of the Public Health Service Act (42 U.S.C. 14
299b–4(a)(1)) is amended by inserting ‘‘, including at 15
least 1 oral health professional’’ before the period at the 16
end. 17
(b) E
FFECTIVEDATE.—The amendment made by 18
subsection (a) shall apply beginning on January 1 of the 19
first year beginning at least 6 months after the date of 20
the enactment of this Act. 21
Æ
VerDate Sep 11 2014 02:56 Jan 12, 2023 Jkt 039200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6301 E:\BILLS\H33.IH H33
kjohnson on DSK79L0C42PROD with BILLS