[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1902 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 1902
To amend title XVIII of the Social Security Act to improve outpatient
vision services under part B of the Medicare Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 1, 2003
Mr. Foley (for himself, Mr. Capuano, Mr. English, Mr. Camp, Mr. Israel,
Mr. Fossella, Mr. Payne, Mr. Goodlatte, Mr. Waxman, Mr. Upton, Mr.
Hinchey, Mr. Abercrombie, Mr. McNulty, Mr. Watt, Mr. Engel, Mr. Weldon
of Florida, Mr. Michaud, Mr. Serrano, Mrs. Christensen, Mr. Kennedy of
Rhode Island, Mr. Hoeffel, Mr. Towns, Mr. Frost, Mr. Allen, Mr. Lynch,
Mr. Doyle, Ms. Corrine Brown of Florida, and Mr. Simmons) introduced
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 improve outpatient
vision services under part B of the Medicare Program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Vision Rehabilitation
Services Act of 2003''.
SEC. 2. IMPROVEMENT OF OUTPATIENT VISION SERVICES UNDER PART B.
(a) Coverage Under Part B.--Section 1861(s)(2) of the Social
Security Act (42 U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (U), by striking ``and'' at the end;
(2) in subparagraph (V), by inserting ``and'' at the end;
and; and
(3) by adding at the end the following new subparagraph:
``(W) vision rehabilitation services (as defined in
subsection (ww)(1));''.
(b) Services Described.--Section 1861 of the Social Security Act
(42 U.S.C. 1395x) is amended by adding at the end the following new
subsection:
``Vision Rehabilitation Services: Vision Rehabilitation Professional
``(ww)(1)(A) The term `vision rehabilitation services' means
rehabilitative services (as determined by the Secretary in regulations)
furnished--
``(i) to an individual diagnosed with a vision impairment
(as defined in paragraph (6)),
``(ii) pursuant to a plan of care established by a
qualified physician (as defined in subparagraph (C)), or by a
qualified occupational therapist, and is periodically reviewed
by the qualified physician,
``(iii) in an appropriate setting (including the home of
the individual receiving such services if specified in the plan
of care), and
``(iv) by any of the following individuals:
``(I) A qualified physician.
``(II) A qualified occupational therapist.
``(III) A vision rehabilitation professional (as
defined in paragraph (2)) while under the general
supervision (as defined in subparagraph (D)) of a
qualified physician.
``(B) In the case of vision rehabilitation services furnished by a
vision rehabilitation professional, the plan of care may only be
established and reviewed by a qualified physician.
``(C) The term `qualified physician' means--
``(i) a physician (as defined in subsection (r)(1)) who is
an ophthalmologist; or
``(ii) a physician (as defined in subsection (r)(4)
(relating to a doctor of optometry)).
``(D) The term `general supervision' means, with respect to a
vision rehabilitation professional, overall direction and control of
that professional by the qualified physician who established the plan
of care for the individual, but the presence of the qualified physician
is not required during the furnishing of vision rehabilitation services
by that professional to the individual.
``(2) The term `vision rehabilitation professional' means any of
the following individuals:
``(A) An orientation and mobility specialist (as defined in
paragraph (3)).
``(B) A rehabilitation teacher (as defined in paragraph
(4)).
``(C) A low vision therapist (as defined in paragraph (5)).
``(3) The term `orientation and mobility specialist' means an
individual who--
``(A) if a State requires licensure or certification of
orientation and mobility specialists, is licensed or certified
by that State as an orientation and mobility specialist;
``(B)(i) holds a baccalaureate or higher degree from an
accredited college or university in the United States (or an
equivalent foreign degree) with a concentration in orientation
and mobility; and
``(ii) has successfully completed 350 hours of clinical
practicum under the supervision of an orientation and mobility
specialist and has furnished not less than 9 months of
supervised full-time orientation and mobility services;
``(C) has successfully completed the national examination
in orientation and mobility administered by the Academy for
Certification of Vision Rehabilitation and Education
Professionals; and
``(D) meets such other criteria as the Secretary
establishes.
``(4) The term `rehabilitation teacher' means an individual who--
``(A) if a State requires licensure or certification of
rehabilitation teachers, is licensed or certified by the State
as a rehabilitation teacher;
``(B)(i) holds a baccalaureate or higher degree from an
accredited college or university in the United States (or an
equivalent foreign degree) with a concentration in
rehabilitation teaching, or holds such a degree in a health field; and
``(ii) has successfully completed 350 hours of clinical
practicum under the supervision of a rehabilitation teacher and
has furnished not less than 9 months of supervised full-time
rehabilitation teaching services;
``(C) has successfully completed the national examination
in rehabilitation teaching administered by the Academy for
Certification of Vision Rehabilitation and Education
Professionals; and
``(D) meets such other criteria as the Secretary
establishes.
``(5) The term `low vision therapist' means an individual who--
``(A) if a State requires licensure or certification of low
vision therapists, is licensed or certified by the State as a
low vision therapist;
``(B)(i) holds a baccalaureate or higher degree from an
accredited college or university in the United States (or an
equivalent foreign degree) with a concentration in low vision
therapy, or holds such a degree in a health field; and
``(ii) has successfully completed 350 hours of clinical
practicum under the supervision of a physician, and has
furnished not less than 9 months of supervised full-time low
vision therapy services;
``(C) has successfully completed the national examination
in low vision therapy administered by the Academy for
Certification of Vision Rehabilitation and Education
Professionals; and
``(D) meets such other criteria as the Secretary
establishes.
``(6) The term `vision impairment' means vision loss that
constitutes a significant limitation of visual capability resulting
from disease, trauma, or a congenital or degenerative condition that
cannot be corrected by conventional means, including refractive
correction, medication, or surgery, and that is manifested by one or
more of the following:
``(A) Best corrected visual acuity of less than 20/60, or
significant central field defect.
``(B) Significant peripheral field defect including
homonymous or heteronymous bilateral visual field defect or
generalized contraction or constriction of field.
``(C) Reduced peak contrast sensitivity in conjunction with
a condition described in subparagraph (A) or (B).
``(D) Such other diagnoses, indications, or other
manifestations as the Secretary may determine to be
appropriate.''.
(c) Payment Under Part B.--
(1) Physician fee schedule.--Section 1848(j)(3) of the
Social Security Act (42 U.S.C. 1395w-4(j)(3)) is amended by
inserting ``(2)(W),'' after ``(2)(S),''.
(2) Carve out from hospital outpatient department
prospective payment system.--Section 1833(t)(1)(B)(iv) of such
Act (42 U.S.C. 1395l(t)(1)(B)(iv)), as redesignated by section
201(e)(1)(B) of the Medicare, Medicaid, and SCHIP Balanced
Budget Refinement Act of 1999 (as enacted into law by section
1000(a)(6) of Public Law 106-113), is amended by inserting
``vision rehabilitation services (as defined in section
1861(ww)(1)), or'' after ``does not include''.
(3) Clarification of billing requirements.--The first
sentence of section 1842(b)(6) of such Act (42 U.S.C.
1395u(b)(6)) is amended--
(A) by striking ``and'' before ``(G)''; and
(B) by inserting before the period the following:
``, and (H) in the case of vision rehabilitation
services (as defined in section 1861(ww)(1)) furnished
by a vision rehabilitation professional (as defined in section
1861(ww)(2)) while under the general supervision (as defined in section
1861(ww)(1)(D)) of a qualified physician (as defined in section
1861(ww)(1)(C)), payment shall be made to (i) the qualified physician
or (ii) the facility (such as a rehabilitation agency, a clinic, or
other facility) through which such services are furnished under the
plan of care if there is a contractual arrangement between the vision
rehabilitation professional and the facility under which the facility
submits the bill for such services''.
(d) Plan of Care.--Section 1835(a)(2) of the Social Security Act
(42 U.S.C. 1395n(a)(2)) is amended--
(1) in subparagraph (E), by striking ``and'' at the end;
(2) in subparagraph (F), by striking the period and
inserting ``; and''; and
(3) by inserting after subparagraph (F) the following new
subparagraph:
``(G) in the case of vision rehabilitation
services, that (i) such services are or were required
because the individual needed vision rehabilitation
services, (ii) an individualized, written plan for
furnishing such services has been established (I) by a
qualified physician (as defined in section
1861(ww)(1)(C)), (II) by a qualified occupational
therapist, or (III) in the case of such services
furnished by a vision rehabilitation professional, by a
qualified physician, (iii) the plan is periodically
reviewed by the qualified physician, and (iv) such
services are or were furnished while the individual is
or was under the care of the qualified physician.''.
(e) Relationship to Rehabilitation Act of 1973.--The provision of
vision rehabilitation services under the medicare program under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) shall not be
taken into account for any purpose under the Rehabilitation Act of 1973
(29 U.S.C. 701 et seq.).
(f) Effective Date.--
(1) Interim, final regulations.--The Secretary shall
publish a rule under this section in the Federal Register by
not later than 180 days after the date of the enactment of this
section to carry out the provisions of this section. Such rule
shall be effective and final immediately on an interim basis,
but is subject to change and revision after public notice and
opportunity for a period (of not less than 60 days) for public
comment.
(2) Consultation.--The Secretary shall consult with the
National Vision Rehabilitation Cooperative, the Association for
Education and Rehabilitation of the Blind and Visually
Impaired, the Academy for Certification of Vision
Rehabilitation and Education Professionals, the American
Academy of Ophthalmology, the American Occupational Therapy
Association, the American Optometric Association, and such
other qualified professional and consumer organizations as the
Secretary determines appropriate in promulgating regulations to
carry out this Act.
<all>
Introduced in House
Introduced in House
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.
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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