; and (2) by adding after clause (i), as added by paragraph (1), the following new clauses: (ii) Special requirements for accreditation of suppliers of orthotics and prosthetics For purposes of applying quality standards under subparagraph (A) for suppliers (other than suppliers described in clause (iii)) of items and services described in subparagraph (D)(ii), the Secretary shall designate and approve independent accreditation organizations under clause (i) only if such organizations are Boards or programs described in subsection (h)(1)(F)(iv). Not later than January 1, 2018, the Secretary shall ensure that at least one, and ideally multiple, independent accreditation organizations are designated and approved in accordance with this clause. (iii) Exception Suppliers described in this clause are physicians, occupational therapists, or physical therapists who are licensed or otherwise regulated by the State in which they are practicing and who receive payment under this title, including regulations promulgated pursuant to this subsection. . (b) Effective date Each organization must satisfy the requirement of section 1834(a)(20)(B)(ii), as added by subsection (a)(2), not later than January 1, 2018, regardless of whether the organization is designated or approved as an independent accreditation organization before, on, or after the date of the enactment of this Act. 3. Application of existing accreditation and licensure requirements to certain prosthetics and custom-fabricated or custom-fitted orthotics (a) In general Section 1834(h)(1)(F) of the Social Security Act ( 42 U.S.C. 1395m(h)(1)(F) ) is amended— (1) in the heading, by inserting or custom-fitted after custom-fabricated ; (2) in clause (i), in the matter preceding subclause (I), by striking an item of custom-fabricated orthotics described in clause (ii) or for an item of prosthetics unless such item is and inserting an item of orthotics or prosthetics, including an item of custom-fabricated orthotics described in clause (ii), unless such item is