Bill > HR1931

This bill amends the Social Security Act to help manufacturers more easily establish national payment rates for innovative pediatric medical technologies. Specifically, the bill creates a process where medical device manufacturers can request the Secretary of Health and Human Services to set national relative value units (a method of determining Medicare payment rates) for qualifying pediatric technologies. A "qualifying pediatric technology" is defined as a medical device that is Medicare-covered, FDA-approved, assigned a temporary medical coding classification, and either primarily used in pediatric procedures or specifically designed for pediatric patients. Manufacturers can submit requests by May 1st to have rates established in the same year, or after May 1st to have rates set in the following year's rulemaking process. The bill requires manufacturers to provide supporting documentation like pricing information, claims data, and usage studies to help establish appropriate payment rates. Importantly, the bill does not mandate Medicare coverage of these technologies and maintains existing coverage determination standards. The goal is to create a more streamlined pathway for bringing innovative pediatric medical devices into the Medicare payment system, potentially improving access to specialized pediatric medical technologies.

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https://www.congress.gov/bill/119th-congress/house-bill/1931/all-info