summary
Introduced
09/18/2023
09/18/2023
In Committee
06/12/2024
06/12/2024
Crossed Over
09/24/2024
09/24/2024
Passed
Dead
01/03/2025
01/03/2025
Introduced Session
118th Congress
Bill Summary
AN ACT To amend title XVIII of the Social Security Act to clarify the application of the in-office ancillary services exception to the physician self-referral prohibition for covered outpatient drugs furnished under the Medicare program, and to provide coverage of external infusion pumps and non-self-administrable home infusion drugs under such program.
AI Summary
This bill aims to address two key provisions related to Medicare coverage. Firstly, it clarifies the application of the in-office ancillary services exception to the physician self-referral prohibition for covered outpatient drugs furnished under Medicare. This allows certain drugs to be picked up or delivered to patients without violating self-referral rules, provided the patient has had a recent face-to-face encounter with the prescriber. Secondly, the bill expands Medicare coverage to include external infusion pumps and non-self-administrable home infusion drugs, provided certain criteria are met, such as the drug requiring administration by a healthcare professional and being infused at least 12 times per year. The bill also appropriates $114 million to the Medicare Improvement Fund.
Committee Categories
Budget and Finance, Business and Industry, Health and Social Services
Sponsors (70)
Diana Harshbarger (R)*,
Colin Allred (D),
Don Bacon (R),
Troy Balderson (R),
Gus Bilirakis (R),
Lisa Blunt Rochester (D),
Larry Bucshon (R),
Nikki Budzinski (D),
Michael Burgess (R),
Yadira Caraveo (D),
Buddy Carter (R),
John Carter (R),
Matt Cartwright (D),
Steve Cohen (D),
Dan Crenshaw (R),
Jason Crow (D),
Anthony D'Esposito (R),
Don Davis (D),
Scott DesJarlais (R),
Jeff Duncan (R),
Neal Dunn (R),
Ron Estes (R),
Drew Ferguson (R),
Chuck Fleischmann (R),
Lizzie Fletcher (D),
Marie Gluesenkamp Pérez (D),
Jared Golden (D),
Josh Gottheimer (D),
Mark Green (R),
Morgan Griffith (R),
Richard Hudson (R),
Jeff Jackson (D),
Bill Johnson (R),
John Joyce (R),
Raja Krishnamoorthi (D),
Ann Kuster (D),
David Kustoff (R),
Darin LaHood (R),
Nick LaLota (R),
Nick Langworthy (R),
Bob Latta (R),
Nicole Malliotakis (R),
Tracey Mann (R),
Carol Miller (R),
Mariannette Miller-Meeks (R),
Nathaniel Moran (R),
Greg Murphy (R),
Troy Nehls (R),
Jay Obernolte (R),
Chris Pappas (D),
August Pfluger (R),
Dean Phillips (D),
Chellie Pingree (D),
Deborah Ross (D),
David Rouzer (R),
Raul Ruiz (D),
John Rutherford (R),
Brad Schneider (D),
Terri Sewell (D),
Darren Soto (D),
Abigail Spanberger (D),
Marilyn Strickland (D),
Tom Tiffany (R),
Dina Titus (D),
Jill Tokuda (D),
Paul Tonko (D),
Jeff Van Drew (R),
Debbie Wasserman Schultz (D),
Randy Weber (R),
Brandon Williams (R),
Last Action
Received in the Senate and Read twice and referred to the Committee on Finance. (on 09/24/2024)
Bill Topics
Health
- ‐ Availability and Affordability of Medical Devices and Equipment
- ‐ Health Insurance Reform
- ‐ Regulation of Drug Industry and Pharmacies
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location | Created |
|---|---|---|
| State Bill Page | https://www.congress.gov/bill/118th-congress/house-bill/5526/all-info | 09/19/2023 |
| BillText | https://www.congress.gov/118/bills/hr5526/BILLS-118hr5526eh.pdf | 09/25/2024 |
| BillText | https://www.congress.gov/118/bills/hr5526/BILLS-118hr5526rh.pdf | 09/20/2024 |
| BillText | https://www.congress.gov/118/bills/hr5526/BILLS-118hr5526ih.pdf | 09/21/2023 |
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