I 

118TH CONGRESS 

1ST SESSION H. R. 6860 

To amend title XVIII of the Social Security Act to clarify and preserve 

the breadth of the protections under the Medicare Secondary Payer Act. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 19, 2023 

Mr. KELLY of Pennsylvania (for himself, Ms. CLARKE of New York, Mr. 

DUNN of Florida, Mr. DAVIS of Illinois, Mr. JOYCE of Pennsylvania, and 

Mr. RUIZ) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, 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 

A BILL 

To amend title XVIII of the Social Security Act to clarify 

and preserve the breadth of the protections under the 

Medicare Secondary Payer Act. 

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 ‘‘Restore Protections 

5 for Dialysis Patients Act’’. 

6 SEC. 2. PURPOSES. 

7 The purposes of this Act are the following: 


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1 (1) To restore the MSPA’s protections for 

2 ESRD patients by ensuring that private health plans 

3 do not discriminate against such patients or ad4 versely classify dialysis as compared to other covered 

5 medical services. 

6 (2) To prohibit health insurance plans from 

7 shifting primary responsibility for covering the cost 

8 of health care services needed by patients with 

9 ESRD to the Medicare program. 

10 (3) To affirm Congress’ intent by clarifying 

11 that singling out dialysis services for disfavored 

12 treatment through coverage limitations as compared 

13 to other covered health services constitutes inappro14 priate differentiations between the benefits provided 

15 to individuals having ESRD and other individuals, 

16 but does not change a plan’s current ability to limit 

17 which renal dialysis providers it includes in the pro18 vider network it elects to offer its enrollees. 

19 SEC. 3. CLARIFICATION AND PRESERVATION OF PROHIBI20 TION UNDER THE MEDICARE PROGRAM. 

21 Section 1862(b)(1)(C) of the Social Security Act (42 

22 U.S.C. 1395y(b)(1)(C)) is amended— 

23 (1) by striking clause (ii) and inserting the fol24 lowing new clause: 


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1 ‘‘(ii) may not differentiate, directly or 

2 indirectly, in the benefits it provides be3 tween individuals obtaining renal dialysis 

4 or having end stage renal disease and 

5 other individuals covered by such plan on 

6 the basis of— 

7 ‘‘(I) the diagnosis of end stage 

8 renal disease; 

9 ‘‘(II) the need for renal dialysis; 

10 or 

11 ‘‘(III) in any other manner;’’; 

12 and 

13 (2) by adding at the end of the matter following 

14 clause (ii) the following new sentences: ‘‘Nothing in 

15 this subsection shall be construed as requiring a 

16 group health plan to include a particular renal dialy17 sis provider as part of the provider network the 

18 group health plan elects to offer its enrollees. The 

19 Secretary shall enforce this subparagraph consistent 

20 with the nonconformance determination require21 ments set forth in part 411 of title 42, Code of Fed22 eral Regulations.’’. 

Æ 


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