II 

116TH CONGRESS 

1ST SESSION S. 1676 

To improve the understanding of, and promote access to treatment for, 

chronic kidney disease, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 23 (legislative day, MAY 22), 2019 

Mr. CARDIN (for himself and Mr. BLUNT) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To improve the understanding of, and promote access to 

treatment for, chronic kidney disease, and for other purposes. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Chronic Kidney Disease Improvement in Research and 

6 Treatment Act of 2019’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—INCREASING AWARENESS, EXPANDING PREVENTIVE 

SERVICES, AND IMPROVING CARE COORDINATION 


kjohnson on DSK79L0C42 with BILLS
2 

•S 1676 IS

Sec. 101. Increasing access to Medicare kidney disease education benefit. 

Sec. 102. Improving patient lives and quality of care through research and innovation. 

Sec. 103. Understanding current utilization of palliative care services. 

Sec. 104. Understanding the progression of kidney disease and treatment of 

kidney failure in minority populations. 

Sec. 105. Improving access in underserved areas. 

Sec. 106. Improving care coordination for dialysis patients by requiring hospitals to provide information. 

TITLE II—INCENTIVIZING INNOVATION FOR TRULY INNOVATIVE 

NEW DRUGS, BIOLOGICALS, DEVICES, AND OTHER TECHNOLOGIES 

Sec. 201. Maintaining an economically stable dialysis infrastructure. 

TITLE III—IMPROVING THE ACCURACY AND TRANSPARENCY OF 

END STAGE RENAL DISEASE QUALITY PROGRAMS 

Sec. 301. Improving patient decision making and transparency by consolidating 

and modernizing quality programs. 

TITLE IV—EMPOWERING PATIENTS 

Sec. 401. Medigap coverage for beneficiaries with end-stage renal disease. 

1 TITLE I—INCREASING AWARE2 NESS, EXPANDING PREVEN3 TIVE SERVICES, AND IMPROV4 ING CARE COORDINATION 

5 SEC. 101. INCREASING ACCESS TO MEDICARE KIDNEY DIS6 EASE EDUCATION BENEFIT. 

7 (a) IN GENERAL.—Section 1861(ggg) of the Social 

8 Security Act (42 U.S.C. 1395x(ggg)) is amended— 

9 (1) in paragraph (1)— 

10 (A) in subparagraph (A), by inserting ‘‘or 

11 stage V’’ after ‘‘stage IV’’; and 

12 (B) in subparagraph (B), by inserting ‘‘or 

13 of a physician assistant, nurse practitioner, or 

14 clinical nurse specialist (as defined in section 


kjohnson on DSK79L0C42 with BILLS
3 

•S 1676 IS

1 1861(aa)(5)) assisting in the treatment of the 

2 individual’s kidney condition’’ after ‘‘kidney 

3 condition’’; and 

4 (2) in paragraph (2)— 

5 (A) by striking subparagraph (B); and 

6 (B) in subparagraph (A)— 

7 (i) by striking ‘‘(A)’’ after ‘‘(2)’’; 

8 (ii) by striking ‘‘and’’ at the end of 

9 clause (i); 

10 (iii) by striking the period at the end 

11 of clause (ii) and inserting ‘‘; and’’; 

12 (iv) by redesignating clauses (i) and 

13 (ii) as subparagraphs (A) and (B), respec14 tively; and 

15 (v) by adding at the end the following: 

16 ‘‘(C) a renal dialysis facility subject to the 

17 requirements of section 1881(b)(1) with per18 sonnel who— 

19 ‘‘(i) provide the services described in 

20 paragraph (1); and 

21 ‘‘(ii) is a physician (as defined in sub22 section (r)(1)) or a physician assistant, 

23 nurse practitioner, or clinical nurse spe24 cialist (as defined in subsection (aa)(5)).’’. 


kjohnson on DSK79L0C42 with BILLS
4 

•S 1676 IS

1 (b) PAYMENT TO RENAL DIALYSIS FACILITIES.— 

2 Section 1881(b) of the Social Security Act (42 U.S.C. 

3 1395rr(b)) is amended by adding at the end the following 

4 new paragraph: 

5 ‘‘(15) For purposes of paragraph (14), the sin6 gle payment for renal dialysis services under such 

7 paragraph shall not take into account the amount of 

8 payment for kidney disease education services (as 

9 defined in section 1861(ggg)). Instead, payment for 

10 such services shall be made to the renal dialysis fa11 cility on an assignment-related basis under section 

12 1848.’’. 

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

14 this section apply to kidney disease education services fur15 nished on or after January 1, 2020. 

16 SEC. 102. IMPROVING PATIENT LIVES AND QUALITY OF 

17 CARE THROUGH RESEARCH AND INNOVA18 TION. 

19 (a) STUDY.—The Secretary of Health and Human 

20 Services (in this section referred to as the ‘‘Secretary’’) 

21 shall conduct a study on increasing kidney transplantation 

22 rates. Such study shall include an analysis of each of the 

23 following: 

24 (1) Any disincentives in the payment systems 

25 under the Medicare program under title XVIII of 


kjohnson on DSK79L0C42 with BILLS
5 

•S 1676 IS

1 the Social Security Act that create barriers to kid2 ney transplants and post-transplant care for bene3 ficiaries with end-stage renal disease. 

4 (2) The practices used by States with higher 

5 than average donation rates and whether those prac6 tices and policies could be successfully utilized in 

7 other States. 

8 (3) Practices and policies that could increase 

9 deceased donation rates of minority populations. 

10 (4) Whether cultural and policy barriers exist to 

11 increasing living donation rates, including an exam12 ination of how to better facilitate chained donations. 

13 (5) Other areas determined appropriate by the 

14 Secretary. 

15 (b) REPORT.—Not later than 18 months after the 

16 date of the enactment of this Act, the Secretary shall sub17 mit to Congress a report on the study conducted under 

18 subsection (a), together with such recommendations as the 

19 Secretary determines to be appropriate. 

20 SEC. 103. UNDERSTANDING CURRENT UTILIZATION OF PAL21 LIATIVE CARE SERVICES. 

22 (a) STUDY.— 

23 (1) IN GENERAL.—The Comptroller General of 

24 the United States (in this section referred to as the 

25 ‘‘Comptroller General’’) shall conduct a study on the 


kjohnson on DSK79L0C42 with BILLS
6 

•S 1676 IS

1 utilization of palliative care in treating individuals 

2 with advanced kidney disease, from stage IV through 

3 stage V, including individuals with kidney failure on 

4 dialysis through any progression of the disease. Such 

5 study shall include an analysis of— 

6 (A) how palliative care can be utilized to 

7 improve the quality of life of those with kidney 

8 disease and facilitate care tailored to their indi9 vidual goals and values; 

10 (B) the successful use of palliative care in 

11 the care of patients with other chronic diseases 

12 and serious illnesses; 

13 (C) the utilization of palliative care at any 

14 point in an illness, including when used at the 

15 same time as curative treatment; and 

16 (D) other areas determined appropriate by 

17 the Comptroller General. 

18 (2) DEFINITION OF PALLIATIVE CARE.—In this 

19 section, the term ‘‘palliative care’’ means patient 

20 and family centered care that optimizes quality of 

21 life by anticipating, preventing, and treating suf22 fering. Such term includes care that is furnished 

23 throughout the continuum of the illness that ad24 dresses physical, intellectual, emotional, social, and 


kjohnson on DSK79L0C42 with BILLS
7 

•S 1676 IS

1 spiritual needs and that facilitates patient autonomy, 

2 access to information and choice. 

3 (b) REPORT.—Not later than 1 year after the date 

4 of the enactment of this Act, the Comptroller General shall 

5 submit to the Congress a report on the study conducted 

6 under subsection (a), together with such recommendations 

7 as the Comptroller General determines to be appropriate. 

8 SEC. 104. UNDERSTANDING THE PROGRESSION OF KIDNEY 

9 DISEASE AND TREATMENT OF KIDNEY FAIL10 URE IN MINORITY POPULATIONS. 

11 (a) STUDY.—The Secretary of Health and Human 

12 Services (in this section referred to as the ‘‘Secretary’’) 

13 shall conduct a study on— 

14 (1) the social, behavioral, and biological factors 

15 leading to kidney disease; 

16 (2) efforts to slow the progression of kidney dis17 ease in minority populations that are disproportion18 ately affected by such disease; and 

19 (3) treatment patterns associated with pro20 viding care, under the Medicare program under title 

21 XVIII of the Social Security Act, the Medicaid pro22 gram under title XIX of such Act, and through pri23 vate health insurance, to minority populations that 

24 are disproportionately affected by kidney failure. 


kjohnson on DSK79L0C42 with BILLS
8 

•S 1676 IS

1 (b) REPORT.—Not later than 1 year after the date 

2 of the enactment of this Act, the Secretary shall submit 

3 to Congress a report on the study conducted under sub4 section (a), together with such recommendations as the 

5 Secretary determines to be appropriate. 

6 SEC. 105. IMPROVING ACCESS IN UNDERSERVED AREAS. 

7 (a) DEFINITION OF PRIMARY CARE SERVICES.—Sec8 tion 331(a)(3)(D) of the Public Health Service Act (42 

9 U.S.C. 254d(a)(3)(D)) is amended by inserting ‘‘renal di10 alysis,’’ after ‘‘dentistry,’’. 

11 (b) NATIONAL HEALTH SERVICE CORPS SCHOLAR12 SHIP PROGRAM.—Section 338A(a)(2) of the Public Health 

13 Service Act (42 U.S.C. 254l(a)(2)) is amended by insert14 ing ‘‘, which may include nephrology health professionals’’ 

15 before the period at the end. 

16 (c) NATIONAL HEALTH SERVICE CORPS LOAN RE17 PAYMENT PROGRAM.—Section 338B(a)(2) of the Public 

18 Health Service Act (42 U.S.C. 254l–1(a)(2)) is amended 

19 by inserting ‘‘, which may include nephrology health pro20 fessionals’’ before the period at the end. 


kjohnson on DSK79L0C42 with BILLS
9 

•S 1676 IS

1 SEC. 106. IMPROVING CARE COORDINATION FOR DIALYSIS 

2 PATIENTS BY REQUIRING HOSPITALS TO 

3 PROVIDE INFORMATION. 

4 Section 1881 of the Social Security Act (42 U.S.C. 

5 1395rr) is amended by adding at the end the following 

6 new subsection: 

7 ‘‘(i) HOSPITALS REQUIRED TO PROVIDE INFORMA8 TION.— 

9 ‘‘(1) IN GENERAL.—The Secretary shall estab10 lish a process under which a hospital or a critical ac11 cess hospital shall provide a renal dialysis facility 

12 with health and treatment information with respect 

13 to an individual who is discharged from the hospital 

14 or critical access hospital and who subsequently re15 ceives treatment at the facility. 

16 ‘‘(2) ELEMENTS.—Under the process estab17 lished under paragraph (1)— 

18 ‘‘(A) the request for health and treatment 

19 information may be initiated by the individual 

20 prior to discharge or upon request by the renal 

21 dialysis facility after the individual is dis22 charged; and 

23 ‘‘(B) the information requested must be 

24 provided to the facility within 7 days of the re25 quest being made.’’. 


kjohnson on DSK79L0C42 with BILLS
10 

•S 1676 IS

1 TITLE II—INCENTIVIZING INNO2 VATION FOR TRULY INNOVA3 TIVE NEW DRUGS, BIOLOGI4 CALS, DEVICES, AND OTHER 

5 TECHNOLOGIES 

6 SEC. 201. MAINTAINING AN ECONOMICALLY STABLE DIALY7 SIS INFRASTRUCTURE. 

8 (a) IN GENERAL.—Section 1881(b)(14) of the Social 

9 Security Act (42 U.S.C. 1395rr(b)(14)) is amended— 

10 (1) in subparagraph (D), in the matter pre11 ceding clause (i), by striking ‘‘Such system’’ and in12 serting ‘‘Subject to subparagraph (J), such system’’; 

13 and 

14 (2) by adding at the end the following new sub15 paragraph: 

16 ‘‘(J) For payment for renal dialysis serv17 ices furnished on or after January 1, 2020, 

18 under the system under this paragraph— 

19 ‘‘(i) the payment adjustment de20 scribed in clause (i) of subparagraph (D)— 

21 ‘‘(I) shall not take into account 

22 comorbidities; and 

23 ‘‘(II) shall only take into account 

24 age for purposes of distinguishing be25 tween individuals who are under 18 


kjohnson on DSK79L0C42 with BILLS
11 

•S 1676 IS

1 years of age and those who are 18 

2 years of age and older but shall not 

3 include any other adjustment for age; 

4 ‘‘(ii) the Secretary shall reassess any 

5 adjustments related to patient weight 

6 under such clause; 

7 ‘‘(iii) the payment adjustment de8 scribed in clause (ii) of such subparagraph 

9 shall not be included; 

10 ‘‘(iv) the standardization factor de11 scribed in the final rule published in the 

12 Federal Register on November 8, 2012 (77 

13 Fed. Reg. 67470), shall be established 

14 using the most currently available data 

15 (and not historical data) and adjusted on 

16 an annual basis, based on such available 

17 data, to account for any change in utiliza18 tion of drugs and any modification in ad19 justors applied under this paragraph; and 

20 ‘‘(v) take into account reasonable 

21 costs for determining the payment rate 

22 consistent with paragraph (2)(B).’’. 

23 (b) INCLUSION OF NETWORK FEE AS AN ALLOW24 ABLE COST.—Section 1881(b)(14) of the Social Security 

25 Act (42 U.S.C. 1395rr(b)(14)), as amended by subsection 


kjohnson on DSK79L0C42 with BILLS
12 

•S 1676 IS

1 (a), is amended by adding at the end the following new 

2 subparagraph: 

3 ‘‘(K) Not later than January 1, 2020, the 

4 Secretary shall amend the ESRD facility cost 

5 report to include the per treatment network fee 

6 (as described in paragraph (7)) as an allowable 

7 cost or offset to revenue.’’. 

8 (c) DETERMINATION OF PRODUCTIVITY ADJUST9 MENT.—Section 1886(b)(3)(B)(xi) of the Social Security 

10 Act (42 U.S.C. 1395ww(b)(3)(B)(xi)) is amended— 

11 (1) in subclause (I), by striking ‘‘For 2012’’ 

12 and inserting ‘‘Subject to subclause (IV), for 2012’’; 

13 and 

14 (2) by adding at the end, the following new sub15 clause: 

16 ‘‘(IV) For each of 2020 through 

17 2024, the productivity adjustment de18 scribed in subclause (II) shall be zero 

19 for a payment system in any year in 

20 which the Medicare Payment Advisory 

21 Commission estimates that payments 

22 under this title pursuant to such pay23 ment system, on an aggregate na24 tional basis, exceed costs, on an agVerDate Sep 11 2014 05:27 Jun 04, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1676.IS S1676

kjohnson on DSK79L0C42 with BILLS
13 

•S 1676 IS

1 gregate national basis, by 3.0 percent 

2 or less.’’. 

3 (d) PAYMENT FOR NEW AND INNOVATIVE DRUGS

4 AND BIOLOGICALS THAT ARE RENAL DIALYSIS SERV5 ICES.—Section 1881(b)(14) of the Social Security Act (42 

6 U.S.C. 1395ww(b)(14)), as amended by subsections (a) 

7 and (b), is amended by adding the following new subpara8 graph— 

9 ‘‘(L) PAYMENT FOR NEW AND INNOVATIVE

10 DRUGS, BIOLOGICALS, AND DEVICES THAT ARE

11 RENAL DIALYSIS SERVICES.— 

12 ‘‘(i) IN GENERAL.—For drugs or 

13 biologicals determined to be within a func14 tional category, the Secretary, in consulta15 tion with stakeholders, shall ensure that 

16 the single payment amount is adequate to 

17 cover the cost of new innovative drugs or 

18 biologicals and increase the single payment 

19 amount if the Secretary determines such 

20 payment amount is not adequate to cover 

21 such cost. In carrying out the preceding 

22 sentence, the Secretary shall use the cost 

23 and utilization data collected during the 

24 two-year transitional payment period, as 

25 described in the final regulation published 


kjohnson on DSK79L0C42 with BILLS
14 

•S 1676 IS

1 on November 14, 2018 (83 Fed. Reg. 

2 56922 et seq.). 

3 ‘‘(ii) MONEY TO FOLLOW THE PA4 TIENT.—The Secretary, through notice 

5 and comment rulemaking, shall implement 

6 a policy for any drug or biological that is 

7 not provided to the ‘average’ patient that 

8 results in the amount by which the single 

9 payment amount is increased pursuant to 

10 this subparagraph shall be paid only when 

11 a provider or renal dialysis facility has 

12 demonstrated that it has administered the 

13 drug or biological to a patient.’’. 

14 (e) NEW DEVICES AND OTHER TECHNOLOGIES.—As 

15 part of the promulgation of the annual rule for the Medi16 care end stage renal disease prospective payment system 

17 under section 1881(b)(14) of the Social Security Act (42 

18 U.S.C. 1395rr(b)(14)) for calendar year 2021, and in con19 sultation with stakeholders, the Secretary shall establish 

20 a process for identifying and determining appropriate pay21 ment amounts for incorporating new devices and tech22 nologies into the bundled payment under such system. 


kjohnson on DSK79L0C42 with BILLS
15 

•S 1676 IS

1 TITLE III—IMPROVING THE AC2 CURACY AND TRANSPARENCY 

3 OF END STAGE RENAL DIS4 EASE QUALITY PROGRAMS 

5 SEC. 301. IMPROVING PATIENT DECISION MAKING AND 

6 TRANSPARENCY BY CONSOLIDATING AND 

7 MODERNIZING QUALITY PROGRAMS. 

8 (a) MEASURES.—Section 1881(h)(2) of the Social 

9 Security Act (42 U.S.C. 1395rr(h)(2)) is amended— 

10 (1) by striking subparagraph (A) and inserting 

11 the following: 

12 ‘‘(A) The measures specified under this 

13 paragraph with respect to the year involved 

14 shall be selected by the Secretary in consulta15 tion with stakeholders to promote improvement 

16 in beneficiary outcomes and shared decision17 making with beneficiaries and their caregivers. 

18 When selecting measures specified under this 

19 paragraph, the Secretary shall take into ac20 count clinical gaps in care, underutilization that 

21 may lead to beneficiary harm, patient safety, 

22 and outcomes.’’; 

23 (2) in subparagraph (B)(i), by striking ‘‘sub24 paragraph (A)(iv)’’ and inserting ‘‘subparagraph 

25 (A)’’; 


kjohnson on DSK79L0C42 with BILLS
16 

•S 1676 IS

1 (3) by striking subparagraph (E); and 

2 (4) by adding at the end the following new sub3 paragraphs: 

4 ‘‘(E) WEIGHTING LIMITATION.—No single 

5 measure specified by the Secretary or individual 

6 measure within a composite measure so speci7 fied may be weighted less than 10 percent of 

8 the total performance score. 

9 ‘‘(F) STATISTICALLY VALID AND RELI10 ABLE.—In specifying measures under subpara11 graph (A), the Secretary shall only specify 

12 measures that have been shown to be statis13 tically valid and reliable through testing.’’. 

14 (b) ENDORSEMENT.—Section 1881(h)(2)(B) of the 

15 Social Security Act (42 U.S.C. 1395rr(h)(2)(B)) is 

16 amended— 

17 (1) in clause (ii), by adding at the end the fol18 lowing new sentence: ‘‘The exception under the pre19 ceding sentence shall not apply to a measure that 

20 the entity with a contract under section 1890(a) (or 

21 a similar entity) considered but failed to endorse.’’; 

22 and 

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

24 clause: 


kjohnson on DSK79L0C42 with BILLS
17 

•S 1676 IS

1 ‘‘(iii) COMPOSITE MEASURES.— 

2 Clauses (i) and (ii) shall apply to com3 posite measures in the same manner as 

4 such clauses apply to individual meas5 ures.’’. 

6 (c) REQUIREMENTS FOR DIALYSIS FACILITY COM7 PARE STAR RATING PROGRAM.—Section 1881(h)(6) of 

8 the Social Security Act (42 U.S.C. 1395rr(h)(6)) is 

9 amended by adding at the end the following new subpara10 graph: 

11 ‘‘(E) REQUIREMENTS FOR ANY DIALYSIS

12 FACILITY COMPARE STAR RATING PROGRAM.— 

13 To the extent that the Secretary maintains a 

14 dialysis facility compare star rating program, 

15 under such a program the Secretary— 

16 ‘‘(i) shall assign stars using the same 

17 methodology and total performance score 

18 results from the quality incentive program 

19 under this subsection; 

20 ‘‘(ii) shall determine the stars using 

21 the same methodology used under such 

22 quality incentive program; and 

23 ‘‘(iii) shall not use a forced bell curve 

24 when determining the stars or rebaselining 

25 the stars.’’. 


kjohnson on DSK79L0C42 with BILLS
18 

•S 1676 IS

1 (d) INCENTIVE PAYMENTS.—Section 1881(h)(1) of 

2 the Social Security Act (42 U.S.C. 1395rr(h)(1)) is 

3 amended by adding at the end the following new subpara4 graph: 

5 ‘‘(D) INCENTIVE PAYMENTS.— 

6 ‘‘(i) IN GENERAL.—In the case of a 

7 provider of services or a renal dialysis fa8 cility that the Secretary determines exceeds 

9 the attainment performance standards 

10 under paragraph (4) with respect to a 

11 year, the Secretary may make a bonus 

12 payment to the provider or facility (pursu13 ant to a process established by the Sec14 retary). 

15 ‘‘(ii) FUNDING.—The total amount of 

16 bonus payments under clause (i) in a year 

17 shall be equal to the total amount of re18 duced payments in a year under subpara19 graph (A). 

20 ‘‘(iii) NO EFFECT IN SUBSEQUENT

21 YEARS.—The provisions of subparagraph 

22 (C) shall apply to a bonus payment under 

23 this subparagraph in the same manner 

24 subparagraph (C) applies to a reduction 

25 under such subparagraph.’’. 


kjohnson on DSK79L0C42 with BILLS
19 

•S 1676 IS

1 (e) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply to items and services furnished on 

3 or after January 1, 2020. 

4 TITLE IV—EMPOWERING 

5 PATIENTS 

6 SEC. 401. MEDIGAP COVERAGE FOR BENEFICIARIES WITH 

7 END-STAGE RENAL DISEASE. 

8 (a) GUARANTEED AVAILABILITY OF MEDIGAP POLI9 CIES TO ALL ESRD MEDICARE BENEFICIARIES.— 

10 (1) IN GENERAL.—Section 1882(s) of the So11 cial Security Act (42 U.S.C. 1395ss(s)) is amend12 ed— 

13 (A) in paragraph (2)— 

14 (i) in subparagraph (A), by striking 

15 ‘‘is 65’’ and all that follows through the 

16 period and inserting the following: ‘‘is— 

17 ‘‘(i) 65 years of age or older and is enrolled for 

18 benefits under part B; or 

19 ‘‘(ii) entitled to benefits under 226A(b) and is 

20 enrolled for benefits under part B.’’; and 

21 (ii) in subparagraph (D), in the mat22 ter preceding clause (i), by inserting ‘‘(or 

23 is entitled to benefits under 226A(b))’’ 

24 after ‘‘is 65 years of age or older’’; and 

25 (B) in paragraph (3)(B)— 


kjohnson on DSK79L0C42 with BILLS
20 

•S 1676 IS

1 (i) in clause (ii), by inserting ‘‘(or is 

2 entitled to benefits under 226A(b))’’ after 

3 ‘‘is 65 years of age or older’’; and 

4 (ii) in clause (vi), by inserting ‘‘(or 

5 under 226A(b))’’ after ‘‘at age 65’’. 

6 (2) EFFECTIVE DATE.—The amendments made 

7 by paragraph (1) shall apply to Medicare supple8 mental policies effective on or after January 1, 

9 2021. 

10 (b) ADDITIONAL ENROLLMENT PERIOD FOR CER11 TAIN INDIVIDUALS.— 

12 (1) ONE-TIME ENROLLMENT PERIOD.— 

13 (A) IN GENERAL.—In the case of an indi14 vidual described in subparagraph (B), the Sec15 retary of Health and Human Services shall es16 tablish a one-time enrollment period during 

17 which such an individual may enroll in any 

18 Medicare supplemental policy under section 

19 1882 of the Social Security Act (42 U.S.C. 

20 1395ss) of the individual’s choosing. 

21 (B) ENROLLMENT PERIOD.—The enroll22 ment period established under subparagraph 

23 (A) shall begin on January 1, 2021, and shall 

24 end June 30, 2021. 


kjohnson on DSK79L0C42 with BILLS
21 

•S 1676 IS

1 (2) INDIVIDUAL DESCRIBED.—An individual de2 scribed in this paragraph is an individual who— 

3 (A) is entitled to hospital insurance bene4 fits under part A of title XVIII of the Social 

5 Security Act under section 226A(b) of such Act 

6 (42 U.S.C. 426–1); 

7 (B) is enrolled for benefits under part B of 

8 such title XVIII; and 

9 (C) would not, but for the provisions of, 

10 and amendments made by, subsection (a) be eli11 gible for the guaranteed issue of a Medicare 

12 supplemental policy under paragraph (2) or (3) 

13 of section 1882(s) of such Act (42 U.S.C. 

14 1395ss(s)). 

Æ 


kjohnson on DSK79L0C42 with BILLS