To establish a pilot project to demonstrate the impact of payment for more frequent hemodialysis treatment under the Medicare Program.

Summary: Access to Better Choice in Dialysis Act of 2006 - Directs the Secretary of Health and Human Services to implement a five-year pilot project to measure the impact of increasing the payment amount otherwise provided under title XVIII (Medicare) of the Social Security Act, based upon the provision of hemodialysis treatment more frequently than three times per week.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Access to Better Choice in Dialysis 
Act of 2006''.

SEC. 2. MEDICARE PILOT PROJECT FOR PAYMENT FOR MORE FREQUENT 
              HEMODIALYSIS TREATMENT.

    (a) In General.--Not later than 6 months after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
implement a 5-year pilot project to measure the impact of increasing 
the payment amount otherwise provided under section 1881(b) of the 
Social Security Act (42 U.S.C. 1395rr(b)), based upon the provision of 
hemodialysis treatment more frequently than 3 times per week.
    (b) Increased Payment Amount.--
            (1) In general.--Under the pilot project, subject to 
        paragraph (2), the increase in payment amount shall be, in the 
        case of hemodialysis treatment provided--
                    (A) for a 4th session in a week, 70 percent of the 
                full composite rate;
                    (B) for a 5th session in a week, 40 percent of the 
                full composite rate;
                    (C) for a 6th session in a week, 30 percent of the 
                full composite rate;
                    (D) for a 7th session in a week, 20 percent of the 
                full composite rate; and
                    (E) for any subsequent session in a week, no 
                additional payment amount.
            (2) Funding limitation.--The pilot program shall be 
        structured in a manner so that the total additional amounts 
        paid under the program for hemodialysis treatment during--
                    (A) its first year of operation does not exceed 
                $15,000,000;
                    (B) its second year of operation does not exceed 
                $30,000,000;
                    (C) its third year of operation does not exceed 
                $50,000,000;
                    (D) its fourth year of operation does not exceed 
                $75,000,000; and
                    (E) its fifth year of operation does not exceed 
                $90,000,000.
        No expenditures shall be made for hemodialysis treatment under 
        the pilot program after its fifth year of operation.
            (3) Funding from smi trust fund.--Funds from the Federal 
        Supplementary Medical Insurance Trust Fund under section 1841 
        of the Social Security Act (42 U.S.C. 1395t) shall be 
        available, in advance of appropriations, to meet obligations 
        arising from the pilot program under this section.
    (c) Data Collection and Analysis.--
            (1) Data collection.--The Secretary shall provide for the 
        collection of data to measure the clinical and financial impact 
        of higher frequency hemodialysis treatments, including its 
        impact on--
                    (A) health status and on the utilization of, and 
                expenditures for, other health care services, including 
                for separately-billable drugs, such as erythropoietin 
                (also known as Epogen), iron, and hospitalizations; and
                    (B) patients' working status, resulting in--
                            (i) a reduction in Social Security 
                        Disability Insurance payments;
                            (ii) increased Federal and State income and 
                        employment tax payments; and
                            (iii) a reduction in Medicare payments due 
                        to increased coverage under employer group 
                        health plans.
            (2) Reports to congress.--The Secretary shall periodically 
        submit to Congress reports on the pilot program under this 
        section. The Secretary shall submit a final report to Congress 
        and to the Medicare Payment Advisory Commission no later than 6 
        months after the completion of the program. Such final report 
        shall include findings regarding the clinical and financial 
        impact of more frequent hemodialysis treatment.
            (3) Medpac analysis.--The Medicare Payment Advisory 
        Commission shall evaluate the Secretary's findings in the final 
        report under paragraph (2) and shall submit to Congress, no 
        later than 6 months after the date of the Commission's receipt 
        of such final report, and shall include in the report its 
        analysis of the desirability of expanded medicare payment for 
        more frequent hemodialysis treatment.
    (d) Definitions.--In this section:
            (1) Full composite rate.--The term ``full composite rate'' 
        means the rate determined under section 1881(b)(7) of the 
        Social Security Act (42 U.S.C. 1395rr(b)(7)).
            (2) Hemodialysis treatment.--The term ``hemodialysis 
        treatment'' includes equivalent therapy requiring blood access, 
        but does not include treatment administered on an emergency or 
        acute basis.
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.