A bill to amend title XVIII of the Social Security Act to provide for coverage and payment for complex rehabilitation technology items under the Medicare program, and for other purposes.
Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015
Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs.
Directs the Secretary of Health and Human Services to: (1) designate CRT items (excluding adaptive equipment to operate motor vehicles or certain prosthetic devices and orthotics), and (2) establish eligibility criteria for them.
Prescribes requirements for payments for CRT items.
Directs the Secretary to establish standards for clinical conditions for CRT item payment as well as quality standards for suppliers of such items.
Directs the Secretary to establish a formal process to allow submission of CRT code set modification requests by stakeholder groups for comprehensive coding changes related to entire policy groups.
Requires payment for replacement of a CRT item (or any part of one), without regard to certain continuous use or useful lifetime restrictions established for items of durable medical equipment, if a qualified ordering practitioner determines that a replacement item (or part) is necessary.
Referred to the Subcommittee on Health.
Introduced in Senate
Read twice and referred to the Committee on Finance.
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