119-hr1931

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1931 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 1931

 To amend title XVIII of the Social Security Act to facilitate patient 
 access to certain pediatric technologies.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 March 6, 2025

Mr. Joyce of Pennsylvania (for himself and Mrs. Trahan) introduced the 
 following bill; which was referred to the Committee on Energy and 
 Commerce, and in addition to the Committee on Ways and Means, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
 committee concerned

_______________________________________________________________________

 A BILL

 To amend title XVIII of the Social Security Act to facilitate patient 
 access to certain pediatric technologies.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Access to Pediatric Technologies Act 
of 2025''.

SEC. 2. FACILITATING ACCESS TO PEDIATRIC TECHNOLOGIES.

    (a) In General.--

Section 1848 of the Social Security Act (42 U.S.C. 
1395w-4) is amended by adding at the end the following new subsection:
 ``

    (u) Facilitating Access to Pediatric Technologies.--
 ``

    (1) In general.--For each qualifying pediatric technology 
 (as defined in paragraph

    (4) ) furnished on or after January 1, 
 2026, the Secretary shall, upon receipt of a manufacturer 
 request under paragraph

    (3) , establish national relative value 
 units under the physician fee schedule established under this 
 section, to the extent no such national relative value units 
 have been established for such qualifying pediatric technology 
 under such fee schedule.
 ``

    (2) Payment methodology.--The Secretary shall establish 
 national relative value units for a qualifying pediatric 
 technology under this subsection--
 ``
        (A) in accordance with the payment methodology 
 established under this section and applicable 
 regulations; and
 ``
        (B) using available data related to the 
 qualifying pediatric technology, which may include 
 applicable contractor pricing information, claims data, 
 time and motion studies, invoice information, or other 
 information used by the Secretary in establishing 
 payment rates.
 ``

    (3) Implementation.--
 ``
        (A) In general.--Upon written request to the 
 Secretary from the manufacturer of a qualifying 
 pediatric technology, the Secretary shall establish 
 national relative value units under paragraph

    (1) through the annual rulemaking process for the physician 
 fee schedule established under this section, in 
 accordance with the timeline described in subparagraph
        (B) .
 ``
        (B) Timeline.--
 ``
            (i) In the case where the Secretary 
 receives a request under this paragraph on or 
 before May 1 of a given year from a 
 manufacturer with respect to a qualifying 
 pediatric technology of the manufacturer, the 
 Secretary shall establish national relative 
 value units for the qualifying pediatric 
 technology in the rulemaking process during 
 that year for the physician fee schedule 
 established under this section.
 ``
            (ii) In the case where the Secretary 
 receives a request under this paragraph after 
 May 1 of a given year from a manufacturer with 
 respect to a qualifying pediatric technology of 
 the manufacturer, the Secretary shall establish 
 national relative value units for the 
 qualifying pediatric technology in the 
 rulemaking process during the following year 
 for the physician fee schedule established 
 under this section.
 ``
            (C) Content of manufacturer requests.--A 
 manufacturer submitting a request under paragraph with 
 respect to a qualifying pediatric technology of the 
 manufacturer shall include in such request information 
 to verify that the technology is a qualifying pediatric 
 technology and to allow the Secretary to establish 
 national relative value units for such technology, 
 including (to the extent available) contractor pricing 
 information, claims data, time and motion studies, 
 invoice information, or other relevant information.
 ``

    (4) Qualifying pediatric technology defined.--In this 
 subsection, the term `qualifying pediatric technology' means a 
 medical device that is--
 ``
        (A) covered under this title;
 ``
        (B) approved, cleared, or authorized under 
 

section 510

    (k) , 513

    (f)

    (2) , or 515 of the Federal Food, 
 Drug, and Cosmetic Act (21 U.S.C. 360

    (k) , 360c

    (f)

    (2) , 
 360e);
 ``
            (C) described by a temporary Level I HCPCS Code 
 intended for emerging technologies, services, or 
 procedures; and
 ``
            (D) 
            (i) used as part of a procedure predominantly 
 performed on pediatric patients; or
 ``
            (ii) has otherwise been specifically designed for 
 safe and effective use in pediatric populations.
 ``

    (5) Rule of construction.--Nothing in this subsection 
 shall be construed to require coverage of a qualifying 
 pediatric technology under this title or alter the requirements 
 of 

section 1862

    (a)

    (1)
        (A) .''.
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