0
0

Access to Pediatric Technologies Act of 2025

3/24/2025, 1:23 PM

Summary of Bill HR 1931

Bill 119 HR 1931, also known as the "Pediatric Device Access Act," aims to make it easier for children to access certain medical technologies under Medicare. The bill proposes amendments to Title XVIII of the Social Security Act, which governs Medicare, in order to streamline the process for pediatric patients to receive necessary devices.

Specifically, the bill seeks to address the challenges that pediatric patients face in obtaining access to medical devices that are not traditionally covered by Medicare. These devices may include specialized equipment for children with disabilities or chronic conditions, such as wheelchairs, prosthetics, or communication devices.

The proposed amendments would establish a process for healthcare providers to request coverage for pediatric devices that are not currently covered by Medicare. This process would involve submitting documentation to demonstrate the medical necessity of the device for the individual patient. Additionally, the bill aims to improve coordination between Medicare and other insurance providers to ensure that pediatric patients have access to the devices they need. This would help to alleviate the financial burden on families who may struggle to afford these specialized devices out of pocket. Overall, the Pediatric Device Access Act is designed to make it easier for pediatric patients to access the medical technologies they need to thrive and improve their quality of life. By streamlining the coverage process and improving coordination between insurance providers, the bill aims to ensure that children have access to the care they need to reach their full potential.

Congressional Summary of HR 1931

Access to Pediatric Technologies Act of 2025

This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish, upon request, specific payment methodologies for qualifying pediatric technologies under the Medicare physician fee schedule. Qualifying pediatric technologies are medical devices that are (1) covered under Medicare, (2) approved by the Food and Drug Administration, (3) currently billed using a specified temporary billing code for emerging technologies, and (4) predominantly used or specifically designated for pediatric patients.

The CMS must develop a payment methodology for a qualifying pediatric technology upon request from the manufacturer and based on available data, including pricing information and claims data. Manufacturers must include relevant information in their requests to enable the CMS to develop the corresponding methodologies.

Current Status of Bill HR 1931

Bill HR 1931 is currently in the status of Bill Introduced since March 6, 2025. Bill HR 1931 was introduced during Congress 119 and was introduced to the House on March 6, 2025.  Bill HR 1931's most recent activity 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. as of March 6, 2025

Bipartisan Support of Bill HR 1931

Total Number of Sponsors
1
Democrat Sponsors
0
Republican Sponsors
1
Unaffiliated Sponsors
0
Total Number of Cosponsors
1
Democrat Cosponsors
1
Republican Cosponsors
0
Unaffiliated Cosponsors
0

Policy Area and Potential Impact of Bill HR 1931

Primary Policy Focus

Alternate Title(s) of Bill HR 1931

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

Comments