I
106TH CONGRESS
2D SESSION
H. R. 5152
To amend title XVIII of the Social Security Act to update the renal dialysis
composite rate.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 12, 2000
Mr. CAMP (for himself, Mrs. THURMAN, Mr. SAM JOHNSON of Texas, Mr.
LEWIS of Georgia, Mr. UPTON, Ms. RIVERS, Mr. PAUL, Mr. GREEN-
WOOD, Mr. HAYWORTH, Mr. MCNULTY, Mr. KLECZKA, Mr. LAFALCE,
Mr. CANADY of Florida, Mr. BRYANT, Mr. DOYLE, Mr. SKELTON, and
Mr. RANGEL) introduced the following bill; which was referred to the
Committee on 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 jurisdic-
tion of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to update
the renal dialysis composite rate.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Medicare Renal Dialy-
sis Payment Fairness Act of 2000’’.
SEC. 2. UPDATE IN RENAL DIALYSIS COMPOSITE RATE.
(a) IN GENERAL.—The last sentence of section
1881(b)(7) of the Social Security Act (42 U.S.C.
1395rr(b)(7)) is amended by striking ‘‘and for such serv-
ices’’ and all that follows before the period at the end and
inserting the following: ‘‘for such services furnished during
2001, by 2.4 percent above such composite rate payment
amounts for such services furnished on December 31,
2000, and for such services furnished during a subsequent
year, by the ESRD market basket percentage increase (in-
cluding any additional factors that may increase costs de-
scribed in paragraph (12)(B)) above such composite rate
payment amounts for such services furnished on December
31 of the previous year’’.
(b) ESRD MARKET BASKET PERCENTAGE INCREASE
DEFINED.—Section 1881(b) of the Social Security Act
(42 U.S.C. 1395rr(b)) is amended by adding at the end
the following new paragraph:
‘‘(12)(A) For purposes of this title, the term ‘ESRD
market basket percentage increase’ means, with respect to
a calendar year, the percentage (estimated by the Sec-
retary before the beginning of such year) by which—
‘‘(i) the cost of the mix of goods and services
included in the provision of dialysis services (includ-
ing the costs described in subparagraph (D)) that is
determined based on an index of appropriately
weighted indicators of changes in wages and prices
which are representative of the mix of goods and
services included in such dialysis services for the cal-
endar year; exceeds
‘‘(ii) the cost of such mix of goods and services
for the preceding calendar year.
‘‘(B) In addition to determining the percentage up-
date under subparagraph (A), the Secretary shall also take
into account any increase in the costs of furnishing the
mix of goods and services described in such subparagraph
resulting from—
‘‘(i) the adoption of scientific and technological
innovations used to provide dialysis services;
‘‘(ii) changes in the manner or method of deliv-
ering dialysis services;
‘‘(iii) productivity improvements in the provi-
sion of dialysis services; and
‘‘(iv) any other relevant factor.
‘‘(C) The Secretary shall periodically review and up-
date (as necessary) the items and services included in the
mix of goods and services used to determine the percent-
age under subparagraph (A).
‘‘(D) The costs described in this subparagraph
include—
‘‘(i) labor, including direct patient care costs
and administrative labor costs, vacation and holiday
pay, payroll taxes, and employee benefits;
‘‘(ii) other direct costs, including drugs, sup-
plies, and laboratory fees;
‘‘(iii) overhead, including medical director fees,
temporary services, general and administrative costs,
interest expenses, and bad debt;
‘‘(iv) capital, including rent, real estate taxes,
depreciation, utilities, repairs, and maintenance; and
‘‘(v) such other allowable costs as the Secretary
may specify.’’.
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