I

107TH CONGRESS

1ST SESSION H. R. 1759

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

under the Medicare Program for more frequent hemodialysis treatments.

IN THE HOUSE OF REPRESENTATIVES

MAY 8, 2001

Mr. MCDERMOTT (for himself and Ms. DUNN of Washington) introduced the

following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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 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’’.
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1 SEC. 2. COVERAGE OF MORE FREQUENT HEMODIALYSIS

2 TREATMENTS.

3 (a) IN GENERAL.—Section 1881(b) of the Social Se4 curity Act (42 U.S.C. 1395rr(b)) is amended—

5 (1) in the first sentence of paragraph (7), by

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

7 payment for more frequent hemodialysis furnished to

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

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

10 paragraph:

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

12 after the date of enactment of this paragraph, the Sec13 retary shall cause to have published in the Federal Reg14 ister final regulations for equivalent per treatment pro15 spective payment rates for more frequent hemodialysis

16 furnished at home and furnished in a facility (commonly

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

18 payment rates), and prospective payment rates for in-facil19 ity training for more frequent hemodialysis.

20 ‘‘(ii) For the year beginning more than 12 months

21 after the date described in clause (i), and for each subse22 quent year, the Secretary shall provide for an appropriate

23 update to the per treatment prospective payment rates de24 veloped under clause (i).
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1 ‘‘(B) In developing per treatment prospective pay2 ment rates under subparagraph (A), the Secretary shall

3 consider—

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

5 frequent hemodialysis programs; and

6 ‘‘(ii) data from the Health Care Financing Ad7 ministration on actual expenditures under this title

8 for more frequent hemodialysis patients, compared

9 to—

10 ‘‘(I) data on expenditures for the same pa11 tients before those patients underwent more fre12 quent hemodialysis, and

13 ‘‘(II) data on expenditures for patients un14 dergoing hemodialysis treatment 3 times per

15 week with similar clinical and demographic

16 characteristics.

17 ‘‘(C) Not later than 1 year after the date of enact18 ment of this paragraph, the Secretary shall develop, in

19 consultation with the renal community, a standard of care

20 and quality standards for more frequent hemodialysis. The

21 Secretary shall periodically review and update as necessary

22 such standards.

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

24 to—
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1 ‘‘(i) documented savings in expenditures under

2 this title by reason of more frequent hemodialysis

3 that are attributable to reduced medications, hos4 pitalizations, outpatient services, and such other fac5 tors as the Secretary determines appropriate; and

6 ‘‘(ii) the improved quality of care and improved

7 outcomes more frequent hemodialysis may bring to

8 patients.

9 ‘‘(E) In this paragraph:

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

11 means hemodialysis treatment sessions, or equivalent

12 therapy requiring blood access, performed at least 5

13 times per week.

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

15 individual who, in the clinical judgment of the physi16 cian of the individual, is likely to achieve better clin17 ical outcomes, quality of life outcomes, or both from

18 more frequent hemodialysis.’’.

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

20 1881(b)(8) of the Social Security Act (42 U.S.C.

21 1395rr(b)(8)) is amended by inserting ‘‘and more frequent

22 hemodialysis supplies and equipment’’ after ‘‘home dialy23 sis supplies and equipment’’.

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

25 1395rr(b)(9)) is amended by inserting ‘‘and more frequent
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1 hemodialysis support services’’ after ‘‘self-care home dialy2 sis support services’’.

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

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

5 of this Act and shall apply with respect to items and serv6 ices furnished on or after the date that is 1 year after

7 such date of enactment.

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