GovTrack’s Bill Summary
We don’t have a summary available yet.
Library of Congress Summary
The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress.
Medicare Durable Medical Equipment Patient Protection Act of 1993 -
Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to designate no more than five regional carriers nationwide to process all claims for durable medical equipment (DME). Prohibits a supplier from presenting a claim for payment unless such claim is presented to the appropriate carrier (i.e., the carrier having jurisdiction over the geographic area of the residence of the patient to whom the item is furnished, with exceptions).
Includes: (1) within the definition of "DME" ostomy and tracheostomy supplies, urologicals, surgical dressings, and splints, casts, and other devices used for reduction of fractures and dislocations; and (2) such supplies in the category of inexpensive and other routinely purchased equipment for payment purposes. Directs the Secretary to: (1) report to the Congress on the feasibility and desirability of basing payment amounts for covered items of DME, prosthetic devices, and orthotics and prosthetics on the reasonable costs of such items; and (2) publish updated guidelines for carriers describing conditions under which such items shall be considered medically effective when furnished to an elderly patient or a disabled patient, and under which a supplier may furnish a patient with an item in excess of, or more expensive than, the standard version for which payment may be made under the program.
Specifies that no payment may be made unless the supplier meets specified certification standards. Directs the Secretary to establish certification standards for suppliers. Authorizes the Secretary to require suppliers to pay an administrative fee and waive or modify certification standards or fee payment under certain circumstances. Prohibits a carrier from issuing more than one provider number to a supplier unless there are significant differences among the items the supplier furnishes or the geographic regions the provider serves. Provides that anti-kickback requirements shall not apply to amounts paid to employees for provision of covered items or services (as under current law), except that any employment relationship between an employee of a nursing facility and a supplier shall not be considered a bona fide employment relationship.
Directs the Secretary to develop a list of suppliers determined to have: (1) engaged in activities which subject them to specified civil or criminal monetary penalties; (2) furnished a substantial number of items for which payment was not made; or (3) engaged in a pattern of overutilization of items. Requires carriers to determine in advance whether payment for an item furnished by a listed supplier may not be made because of coverage exclusions. (Secs. 6 and 7) Directs the Comptroller General to study and report to the Congress on: (1) the impact of this Act on access to, and costs of, DME for Medicare beneficiaries; and (2) the types, volume, and utilization of DME furnished to Medicare beneficiaries residing in skilled nursing and intermediate care facilities. Sets forth reporting requirements.
House Republican Conference Summary
The summary below was written by the House Republican Conference, which is the caucus of Republicans in the House of Representatives.
No summary available.
House Democratic Caucus Summary
The House Democratic Caucus does not provide summaries of bills.
So, yes, we display the House Republican Conference’s summaries when available even if we do not have a Democratic summary available. That’s because we feel it is better to give you as much information as possible, even if we cannot provide every viewpoint.
We’ll be looking for a source of summaries from the other side in the meanwhile.