DURABLE MEDICAL EQUIPMENT.

SEC. 6112. DURABLE MEDICAL EQUIPMENT. (a) Delay in and Reduction of Update for 1990.— (1) Inexpensive and routinely purchased durable medical equipment and items requiring frequent and substantial servicing.—Paragraphs (2)(B)(i) and (3)(B)(i) of section 1834(a) of the Social Security Act (42 U.S.C. 1395m(a)) are each amended by striking “in 1989” and inserting “in 1989 and in 1990”. (2) Miscellaneous devices and items and other covered items.— Paragraph (8)(A)(ii) of such section is amended— (A) in subclause (I), by striking “1989” and inserting “1989 and 1990”, and (B) in subclause (II), by striking “1990, 1991,” and inserting “1991”. (3) Oxygen and oxygen equipment.— Paragraph (9)(A)(ii) of such section is amended— (A) in subclause (I), by striking “1989” and inserting “1989 and 1990”, and (B) in subclause (II), by striking “1990, 1991,” and inserting “1991”. (4) Conforming amendments.— Such section is further amended— (A) in paragraph (7)(A)(i), by striking “this subparagraph” and inserting “this clause”; (B) in paragraph (7)(B)(i), by inserting “in” after “rental of the item”; and 103 STAT. 2215 (C) in paragraph (7)(B)(ii), by striking “the payment amount” and all that follows and inserting “clause (i) shall apply in the same manner as it applies to items furnished during 1989.”. (b) Rental Payments for Enteral and Parenteral Pumps.— (1) In general.—Except as provided in paragraph (2), the amount of any monthly rental payment under part B of title XVIII of the Social Security Act for an enteral or parenteral pump furnished on or after April 1, 1990, shall be determined in accordance with the methodology under which monthly rental payments for such pumps were determined during 1989. (2) Cap on Rental Payments, Servicing, and Repairs.— In the case of an enteral or parenteral pump described in paragraph (1) that is furnished on a rental basis during a period of medical need— (A) monthly rental payments shall not be made under part B of title XVIII of the Social Security Act for more than 15 months during such period, and (B) after monthly rental payments have been made for 15 months during such period, payment under such part shall be made for maintenance and servicing of the pump in such amounts as the Secretary of Health and Human Services determines to be reasonable and necessary to ensure the proper operation of the pump. (c) Reduction in Fee Schedules for Seat-Lift Chairs and Transcutaneous Electrical Nerve Stimulators.—Paragraph (1) of such section 1834(a) is amended by adding at the end the following new subparagraph: “(D) Reduction in fee schedules for certain items.—With respect to a seat-lift chair or transcutaneous electrical nerve stimulator furnished on or after April 1, 1990, the Secretary shall reduce the payment amount applied under subparagraph (B)(ii) for such an item by 15 percent.”. (d) Treatment of Power Driven Wheelchairs.— (1) As routinely purchased.— Section 1834(a)(2)(A) of the Social Security Act (42 U.S.C. 1395m(a)(2)(A)) is amended— (A) by striking “or” at the end of clause (i), (B) by adding “or” at the end of clause (ii), and (C) by inserting after clause (ii) the following new clause: “(iii) which is a power-driven wheelchair (other than a customized wheelchair that is classified as a customized item under paragraph (4) pursuant to criteria specified by the Secretary),”. (2) As customized item.—The Secretary of Health and Human Services shall by regulation specify criteria to be used by carriers in making determinations on a case-by-case basis as whether to classify power-driven wheelchairs as a customized item (as described in section 1834(a)(4) of the Social Security Act) for purposes of reimbursement under title XVIII of such Act. (e) Ostomy Supplies as Part of Home Health Services.— (1) Specific inclusion in home health services.—Section 1861(m)(5) of the Social Security Act (42 U.S.C. 1395x(m)(5)) is amended to read as follows: “(5) medical supplies (including catheters, catheter supplies, ostomy bags, and supplies related to ostomy care, but excluding 103 STAT. 2216drugs and biologicals) and durable medical equipment while under such a plan;”. (2) Exclusion from covered items.—Section 1834(a)(13) of such Act (42 U.S.C. 1395m(a)(13)) is amended by inserting after “intraocular lenses” the following: “or medical supplies (including catheters, catheter supplies, ostomy bags, and supplies related to ostomy care) furnished by a home health agency under section 1861(m)(5)”. (3) Requiring provision as part of home health services.— Section 1866(a)(1) of such Act (42 U.S.C. 1395cc(a)(1)) is amended— (A) by striking “and” at the end of subparagraph (N), (B) by striking the period at the end of subparagraph (O) and inserting “; and”, (C) and by inserting after subparagraph (O) the following new subparagraph: “(P) in the case of home health agencies which provide home health services to individuals entitled to benefits under this title who require ostomy supplies (described in section 1861(m)(5)), to offer to furnish such supplies to such an individual as part of their furnishing of home health services.”. (4) Effective date.—The amendments made by this subsection shall apply with respect to items furnished on or after January 1, 1990.