Us Congress 2025-2026 Regular Session

Us Congress House Bill HB1931 Compare Versions

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Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 1931
5	5	To amend title XVIII of the Social Security Act to facilitate patient access
6	6	to certain pediatric technologies.
7	7	IN THE HOUSE OF REPRESENTATIVES
8	8	MARCH6, 2025
9	9	Mr. J
10	10	OYCEof Pennsylvania (for himself and Mrs. TRAHAN) introduced the fol-
11	11	lowing bill; which was referred to the Committee on Energy and Com-
12	12	merce, and in addition to the Committee on Ways and Means, for a pe-
13	13	riod to be subsequently determined by the Speaker, in each case for con-
14	14	sideration of such provisions as fall within the jurisdiction of the com-
15	15	mittee concerned
16	16	A BILL
17	17	To amend title XVIII of the Social Security Act to facilitate
18	18	patient access to certain pediatric technologies.
19	19	Be it enacted by the Senate and House of Representa-1
20	20	tives of the United States of America in Congress assembled, 2
21	21	SECTION 1. SHORT TITLE. 3
22	22	This Act may be cited as the ‘‘Access to Pediatric 4
23	23	Technologies Act of 2025’’. 5
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26	26	•HR 1931 IH
27	27	SEC. 2. FACILITATING ACCESS TO PEDIATRIC TECH-1
28	28	NOLOGIES. 2
29	29	(a) I
30	30	NGENERAL.—Section 1848 of the Social Secu-3
31	31	rity Act (42 U.S.C. 1395w–4) is amended by adding at 4
32	32	the end the following new subsection: 5
33	33	‘‘(u) F
34	34	ACILITATINGACCESS TOPEDIATRICTECH-6
35	35	NOLOGIES.— 7
36	36	‘‘(1) I
37	37	N GENERAL.—For each qualifying pedi-8
38	38	atric technology (as defined in paragraph (4)) fur-9
39	39	nished on or after January 1, 2026, the Secretary 10
40	40	shall, upon receipt of a manufacturer request under 11
41	41	paragraph (3), establish national relative value units 12
42	42	under the physician fee schedule established under 13
43	43	this section, to the extent no such national relative 14
44	44	value units have been established for such qualifying 15
45	45	pediatric technology under such fee schedule. 16
46	46	‘‘(2) P
47	47	AYMENT METHODOLOGY .—The Secretary 17
48	48	shall establish national relative value units for a 18
49	49	qualifying pediatric technology under this sub-19
50	50	section— 20
51	51	‘‘(A) in accordance with the payment 21
52	52	methodology established under this section and 22
53	53	applicable regulations; and 23
54	54	‘‘(B) using available data related to the 24
55	55	qualifying pediatric technology, which may in-25
56	56	clude applicable contractor pricing information, 26
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59	59	•HR 1931 IH
60	60	claims data, time and motion studies, invoice 1
61	61	information, or other information used by the 2
62	62	Secretary in establishing payment rates. 3
63	63	‘‘(3) I
64	64	MPLEMENTATION.— 4
65	65	‘‘(A) I
66	66	N GENERAL.—Upon written request 5
67	67	to the Secretary from the manufacturer of a 6
68	68	qualifying pediatric technology, the Secretary 7
69	69	shall establish national relative value units 8
70	70	under paragraph (1) through the annual rule-9
71	71	making process for the physician fee schedule 10
72	72	established under this section, in accordance 11
73	73	with the timeline described in subparagraph 12
74	74	(B). 13
75	75	‘‘(B) T
76	76	IMELINE.— 14
77	77	‘‘(i) In the case where the Secretary 15
78	78	receives a request under this paragraph on 16
79	79	or before May 1 of a given year from a 17
80	80	manufacturer with respect to a qualifying 18
81	81	pediatric technology of the manufacturer, 19
82	82	the Secretary shall establish national rel-20
83	83	ative value units for the qualifying pedi-21
84	84	atric technology in the rulemaking process 22
85	85	during that year for the physician fee 23
86	86	schedule established under this section. 24
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89	89	•HR 1931 IH
90	90	‘‘(ii) In the case where the Secretary 1
91	91	receives a request under this paragraph 2
92	92	after May 1 of a given year from a manu-3
93	93	facturer with respect to a qualifying pedi-4
94	94	atric technology of the manufacturer, the 5
95	95	Secretary shall establish national relative 6
96	96	value units for the qualifying pediatric 7
97	97	technology in the rulemaking process dur-8
98	98	ing the following year for the physician fee 9
99	99	schedule established under this section. 10
100	100	‘‘(C) C
101	101	ONTENT OF MANUFACTURER RE -11
102	102	QUESTS.—A manufacturer submitting a request 12
103	103	under paragraph with respect to a qualifying 13
104	104	pediatric technology of the manufacturer shall 14
105	105	include in such request information to verify 15
106	106	that the technology is a qualifying pediatric 16
107	107	technology and to allow the Secretary to estab-17
108	108	lish national relative value units for such tech-18
109	109	nology, including (to the extent available) con-19
110	110	tractor pricing information, claims data, time 20
111	111	and motion studies, invoice information, or 21
112	112	other relevant information. 22
113	113	‘‘(4) Q
114	114	UALIFYING PEDIATRIC TECHNOLOGY DE -23
115	115	FINED.—In this subsection, the term ‘qualifying pe-24
116	116	diatric technology’ means a medical device that is— 25
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119	119	•HR 1931 IH
120	120	‘‘(A) covered under this title; 1
121	121	‘‘(B) approved, cleared, or authorized 2
122	122	under section 510(k), 513(f)(2), or 515 of the 3
123	123	Federal Food, Drug, and Cosmetic Act (21 4
124	124	U.S.C. 360(k), 360c(f)(2), 360e); 5
125	125	‘‘(C) described by a temporary Level I 6
126	126	HCPCS Code intended for emerging tech-7
127	127	nologies, services, or procedures; and 8
128	128	‘‘(D)(i) used as part of a procedure pre-9
129	129	dominantly performed on pediatric patients; or 10
130	130	‘‘(ii) has otherwise been specifically de-11
131	131	signed for safe and effective use in pediatric 12
132	132	populations. 13
133	133	‘‘(5) R
134	134	ULE OF CONSTRUCTION .—Nothing in 14
135	135	this subsection shall be construed to require cov-15
136	136	erage of a qualifying pediatric technology under this 16
137	137	title or alter the requirements of section 17
138	138	1862(a)(1)(A).’’. 18
139	139	Æ
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