I 
111TH CONGRESS 
2D SESSION 
H. R. 6537 
To amend titles XVIII and XIX of the Social Security Act and other Acts 
to improve Medicare and other benefits for beneficiaries with kidney 
disease, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 16, 2010 
Mr. LEWIS of Georgia 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 titles XVIII and XIX of the Social Security Act 
and other Acts to improve Medicare and other benefits 
for beneficiaries with kidney disease, and for other pur-
poses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Improving Care for Kidney Patients Act of 2010’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
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Sec. 1. Short title; table of contents. 
TITLE I—IMPROVING PATIENT CARE 
Sec. 101. Improvement of pre-dialysis care for Medicaid beneficiaries. 
Sec. 102. Study the progression kidney disease in minority populations. 
Sec. 103. AHRQ recommendations on dialysis quality and care management re-
search gaps. 
Sec. 104. Kidney disease screening. 
Sec. 105. Kidney disease education in hospitals. 
Sec. 106. Increasing access to medicare kidney disease education benefit. 
Sec. 107. Kidney disease accountable care organizations (ACOs). 
Sec. 108. Coordination of care between hospitals and renal dialysis facilities. 
Sec. 109. Clarification of coverage of certain occulsive dressings. 
TITLE II—PROVIDING ACCESS TO PATIENTS IN NEED OF 
DIALYSIS TREATMENT 
Sec. 201. Survey requirements for renal dialysis facilities. 
Sec. 202. GAO study on transportation barriers to accessing kidney care. 
Sec. 203. Vascular access care service sites. 
TITLE III—ELIMINATING INEQUITIES FOR PATIENTS WITH 
KIDNEY FAILURE 
Sec. 301. Patient choice of primary insurer. 
Sec. 302. Access to medigap policies. 
Sec. 303. Protecting individuals with kidney failure from unfair practices under 
health care reform. 
TITLE I—IMPROVING PATIENT 
CARE 
SEC. 101. IMPROVEMENT OF PRE-DIALYSIS CARE FOR MED-
ICAID BENEFICIARIES. 
(a) IN GENERAL.—Section 1905(b) of the Social Se-
curity Act (42 U.S.C. 1396d(b)) is amended by adding 
at the end the following new sentence: ‘‘Notwithstanding 
the first sentence of this subsection, the Federal medical 
assistance percentage with respect to the placement of an 
arteriovenous fistula or graft for purposes of hemodialysis 
treatment shall be 100 percent’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) apply to fistulas and grafts placed on or 
after January 1, 2011. 
SEC. 102. STUDY THE PROGRESSION KIDNEY DISEASE IN 
MINORITY POPULATIONS. 
Not later than one year after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services, acting through the Director of the Agency for 
Healthcare Research and Quality, shall complete a study 
(and submit a report to Congress) on— 
(1) the social, behavioral, and biological factors 
leading to kidney disease; and 
(2) efforts to slow the progression of kidney dis-
ease in minority populations that are disproportion-
ately affected by such disease. 
SEC. 103. AHRQ RECOMMENDATIONS ON DIALYSIS QUALITY 
AND CARE MANAGEMENT RESEARCH GAPS. 
Not later than 2 years after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services, acting through the Director of the Agency for 
Healthcare Research and Quality, shall submit to Con-
gress a report regarding the research gaps with respect 
to the development of quality measures and care manage-
ment for patients with end-stage renal disease, including 
pediatric patients. Such report shall include recommenda-
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tions about undertaking research to fill such gaps and 
prioritizing such research. 
SEC. 104. KIDNEY DISEASE SCREENING. 
(a) IN GENERAL.—Section 1128B(b)(3) of the Social 
Security Act (42 U.S.C. 1320a–7b(b)(3)) is amended— 
(1) by striking ‘‘and’’ at the end of subpara-
graph (I); 
(2) in subparagraph (J), by moving the inden-
tation 2 ems to the left and by striking the period 
at the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(K) a waiver of any fee or cost-sharing by 
a renal dialysis facility for the purpose of pro-
viding screening for chronic kidney disease so 
long as— 
‘‘(i) receiving the screening is not con-
ditioned on the individual’s use of any 
other goods or services from the facility or 
any other particular health care provider; 
‘‘(ii) individuals receiving the screen-
ing are referred to their own health care 
practitioner; 
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