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107TH CONGRESS

1ST SESSION S. 1303

To amend title XVIII of the Social Security Act to provide for payment

under the medicare program for more frequent hemodialysis treatments.

IN THE SENATE OF THE UNITED STATES

AUGUST 2, 2001

Mr. KERRY introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to provide

for payment under the medicare program for more frequent hemodialysis treatments.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Kidney Patient Daily

5 Dialysis Quality Act of 2001’’.

6 SEC. 2. COVERAGE OF MORE FREQUENT HEMODIALYSIS

7 TREATMENTS.

8 (a) IN GENERAL.—Section 1881(b) of the Social Se9 curity Act (42 U.S.C. 1395rr(b)) is amended—
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1 (1) in the first sentence of paragraph (7), by

2 inserting before the period the following: ‘‘, including

3 payment for more frequent hemodialysis furnished to

4 qualified individuals under paragraph (12)’’; and

5 (2) by adding at the end the following new

6 paragraph:

7 ‘‘(12)(A)(i) Not later than the date that is 1 year

8 after the date of enactment of this paragraph, the Sec9 retary shall cause to have published in the Federal Reg10 ister final regulations for equivalent per treatment pro11 spective payment rates for more frequent hemodialysis

12 furnished at home and furnished in a facility (commonly

13 known as composite ‘Method I’ rates and ‘Method II Cap’

14 payment rates), and prospective payment rates for in-facil15 ity training for more frequent hemodialysis.

16 ‘‘(ii) For the first year beginning more than 12

17 months after the date described in clause (i), and for each

18 subsequent year, the Secretary shall provide for an appro19 priate update to the per treatment prospective payment

20 rates developed under clause (i).

21 ‘‘(B) In developing per treatment prospective pay22 ment rates under subparagraph (A), the Secretary shall

23 consider—

24 ‘‘(i) actual reasonable costs of operating more

25 frequent hemodialysis programs; and
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1 ‘‘(ii) data from the Centers for Medicare &

2 Medicaid Services on actual expenditures under this

3 title for more frequent hemodialysis patients, com4 pared to—

5 ‘‘(I) data on expenditures for the same pa6 tients before those patients underwent more fre7 quent hemodialysis, and

8 ‘‘(II) data on expenditures for patients un9 dergoing hemodialysis treatment 3 times per

10 week with similar clinical and demographic

11 characteristics.

12 ‘‘(C) Not later than 1 year after the date of enact13 ment of this paragraph, the Secretary shall develop, in

14 consultation with the renal community, a standard of care

15 and quality standards for more frequent hemodialysis. The

16 Secretary shall periodically review and update as necessary

17 such standards.

18 ‘‘(D) The Secretary shall collect data with respect

19 to—

20 ‘‘(i) documented savings in expenditures under

21 this title by reason of more frequent hemodialysis

22 that are attributable to reduced medications, hos23 pitalizations, outpatient services, and such other fac24 tors as the Secretary determines appropriate; and
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1 ‘‘(ii) the improved quality of care and improved

2 outcomes more frequent hemodialysis may bring to

3 patients.

4 ‘‘(E) In this paragraph:

5 ‘‘(i) The term ‘more frequent hemodialysis’

6 means hemodialysis treatment sessions, or equivalent

7 therapy requiring blood access, performed at least 5

8 times per week.

9 ‘‘(ii) The term ‘qualified individual’ means an

10 individual who, in the clinical judgment of the physi11 cian of the individual, is likely to achieve better clin12 ical outcomes, quality of life outcomes, or both from

13 more frequent hemodialysis.’’.

14 (b) CONFORMING AMENDMENTS.—(1) Section

15 1881(b)(8) of the Social Security Act (42 U.S.C.

16 1395rr(b)(8)) is amended by inserting ‘‘and more frequent

17 hemodialysis supplies and equipment’’ after ‘‘home dialy18 sis supplies and equipment’’.

19 (2) Section 1881(b)(9) of such Act (42 U.S.C.

20 1395rr(b)(9)) is amended by inserting ‘‘and more frequent

21 hemodialysis support services’’ after ‘‘self-care home dialy22 sis support services’’.

23 (c) EFFECTIVE DATE.—The amendments made by

24 this section shall take effect on the date of the enactment

25 of this Act and shall apply with respect to items and serv-
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1 ices furnished on or after the date that is 1 year after

2 such date of enactment.

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