Page:United States Statutes at Large Volume 117.djvu/2243

 117 STAT. 2224

PUBLIC LAW 108–173—DEC. 8, 2003 (2) ESTABLISHMENT

OF CLINICAL CONDITIONS OF COVERAGE STANDARDS FOR ITEMS OF DURABLE MEDICAL EQUIPMENT.—Sec-

tion 1834(a)(1) (42 U.S.C. 1395m(a)(1)) is amended by adding at the end the following new subparagraph: ‘‘(E) CLINICAL CONDITIONS FOR COVERAGE.— ‘‘(i) IN GENERAL.—The Secretary shall establish standards for clinical conditions for payment for covered items under this subsection. ‘‘(ii) REQUIREMENTS.—The standards established under clause (i) shall include the specification of types or classes of covered items that require, as a condition of payment under this subsection, a face-to-face examination of the individual by a physician (as defined in section 1861(r)(1)), a physician assistant, nurse practitioner, or a clinical nurse specialist (as those terms are defined in section 1861(aa)(5)) and a prescription for the item. ‘‘(iii) PRIORITY OF ESTABLISHMENT OF STANDARDS.— In establishing the standards under this subparagraph, the Secretary shall first establish standards for those covered items for which the Secretary determines there has been a proliferation of use, consistent findings of charges for covered items that are not delivered, or consistent findings of falsification of documentation to provide for payment of such covered items under this part. ‘‘(iv) STANDARDS FOR POWER WHEELCHAIRS.—Effective on the date of the enactment of this subparagraph, in the case of a covered item consisting of a motorized or power wheelchair for an individual, payment may not be made for such covered item unless a physician (as defined in section 1861(r)(1)), a physician assistant, nurse practitioner, or a clinical nurse specialist (as those terms are defined in section 1861(aa)(5)) has conducted a face-to-face examination of the individual and written a prescription for the item. ‘‘(v) LIMITATION ON PAYMENT FOR COVERED ITEMS.—Payment may not be made for a covered item under this subsection unless the item meets any standards established under this subparagraph for clinical condition of coverage.’’. (b) COMPETITIVE ACQUISITION.— (1) IN GENERAL.—Section 1847 (42 U.S.C. 1395w–3) is amended to read as follows:

Effective date.

‘‘COMPETITIVE

Contracts.

VerDate 11-MAY-2000

13:59 Aug 30, 2004

ACQUISITION OF CERTAIN ITEMS AND SERVICES

‘‘SEC. 1847. (a) ESTABLISHMENT OF COMPETITIVE ACQUISITION PROGRAMS.— ‘‘(1) IMPLEMENTATION OF PROGRAMS.— ‘‘(A) IN GENERAL.—The Secretary shall establish and implement programs under which competitive acquisition areas are established throughout the United States for contract award purposes for the furnishing under this part of competitively priced items and services (described in paragraph (2)) for which payment is made under this part. Such areas may differ for different items and services. ‘‘(B) PHASED-IN IMPLEMENTATION.—The programs—

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