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Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC eyeglass exclusion applies to more than lenses in frames worn around the nose and ears. In referring to the eyeglass exclusion, the Medicare statute uses various terms, such as eyeglasses, eyewear, conventional eyeglasses and contact lenses, which strongly indicates that the eyeglass exclusion applies to more than just conventional eyeglasses. Additional evidence of Congressional intent regarding the meaning of the term “eyeglasses” can be found in the conference report accompanying the original legislation in 1965 (S Rep. No. 89-404, 49). Although the original statutory language referred to eyeglasses, the conference report also referred to contact lenses, suggesting that the Congress did not intend to construe the term narrowly. We also note that there is nothing in either the Medicare statutory language of the eyeglass coverage exclusion or the accompanying legislative history to suggest that the exclusion is limited to lenses used to correct refractive errors or other types of specific visual problems; rather, it is stated without reference to any particular types of visual problems. Additionally, to the extent there is some ambiguity (as noted above in our discussion of the Currier case, where the court noted that ambiguity exists with respect to 994
CMS-1403-FC this statutory exclusion and low vision aids), the Supreme Court recognizes that a prior judicial construction of an ambiguous statute does not categorically control an agency’s contrary construction. As noted above, we understand that some may believe a more narrow interpretation would be appropriate in this instance. We disagree and continue to believe we have interpreted the Medicare statute in a way that best captures the Congress’ intent and that our interpretation is a reasonable and permissible reading of the statutory exclusion. Furthermore, we have followed the necessary procedures set forth under the Administrative Procedures Act for agencies to follow in establishing interpretive rules to ensure that this regulatory clarification of our longstanding Medicare policy has been given the appropriate consideration and review. Finally, as noted in more detail below, if an item or service falls within a benefit category, it must not be otherwise excluded, in order for coverage to be considered. Thus, whether an item that falls within the scope of statutory exclusion clarified by this regulation falls within a defined Medicare benefit category, does not alter the analysis as to whether the statutory exclusion for eyeglasses may apply. 995
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<strong>CMS</strong>-1403-FC<br />
eyeglass exclusion applies to more than lenses in frames<br />
worn around the nose and ears. In referring to the<br />
eyeglass exclusion, the Medicare statute uses various<br />
terms, such as eyeglasses, eyewear, conventional eyeglasses<br />
and contact lenses, which strongly indicates that the<br />
eyeglass exclusion applies to more than just conventional<br />
eyeglasses. Additional evidence of Congressional intent<br />
regarding the meaning of the term “eyeglasses” can be found<br />
in the conference report accompanying the original<br />
legislation in 1965 (S Rep. No. 89-404, 49). Although the<br />
original statutory language referred to eyeglasses, the<br />
conference report also referred to contact lenses,<br />
suggesting that the Congress did not intend to construe the<br />
term narrowly.<br />
We also note that there is nothing in either the<br />
Medicare statutory language of the eyeglass coverage<br />
exclusion or the accompanying legislative history to<br />
suggest that the exclusion is limited to lenses used to<br />
correct refractive errors or other types of specific visual<br />
problems; rather, it is stated without reference to any<br />
particular types of visual problems.<br />
Additionally, to the extent there is some ambiguity<br />
(as noted above in our discussion of the Currier case,<br />
where the court noted that ambiguity exists with respect to<br />
994