(B) REPORT.—Not later than 6 months 
after the date on which the demonstration 
projects under this subsection are completed, 
the Secretary shall submit to Congress a report 
on the evaluation conducted under subpara-
graph (A) together with recommendations for 
such legislation and administrative action as the 
Secretary determines appropriate. 
(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection $2,000,000 for each of fiscal years 
2009 through 2013. 
(b) ESRD SELF-MANAGEMENT
DEMONSTRATION 
PROJECTS.— 
(1) IN GENERAL.—The Secretary shall establish 
demonstration projects to enable individuals with 
end-stage renal disease to develop self-management 
skills. 
(2) APPLICATION.—The provisions of para-
graph (2) (relating to scope and duration) and para-
graph (3) (relating to an evaluation and a report) of 
subsection (a) shall apply to the demonstration 
projects under this subsection in the same manner 
as such provisions apply to the demonstration 
projects under subsection (a). 
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(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection $2,000,000 for each of fiscal years 
2009 through 2013. 
SEC. 102. MEDICARE COVERAGE OF KIDNEY DISEASE PA-
TIENT EDUCATION SERVICES. 
(a) COVERAGE
OF KIDNEY DISEASE EDUCATION 
SERVICES.— 
(1) COVERAGE.—Section 1861(s)(2) of the So-
cial Security Act (42 U.S.C. 1395x(s)(2)) is amend-
ed— 
(A) in subparagraph (Z), by striking 
‘‘and’’ after the semicolon at the end; 
(B) in subparagraph (AA), by adding 
‘‘and’’ after the semicolon at the end; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(BB) kidney disease education services 
(as defined in subsection (ccc));’’. 
(2) SERVICES
DESCRIBED.—Section 1861 of 
the Social Security Act (42 U.S.C. 1395x) is amend-
ed by adding at the end the following new sub-
section: 
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‘‘Kidney Disease Education Services 
‘‘(ccc)(1) The term ‘kidney disease education serv-
ices’ means educational services that are— 
‘‘(A) furnished to an individual with kidney dis-
ease who, according to accepted clinical guidelines 
identified by the Secretary, will require dialysis or a 
kidney transplant; 
‘‘(B) furnished, upon the referral of the physi-
cian managing the individual’s kidney condition, by 
a qualified person (as defined in paragraph (2)); and 
‘‘(C) designed— 
‘‘(i) to provide comprehensive information 
regarding— 
‘‘(I) the management of comorbidities; 
‘‘(II) the prevention of uremic com-
plications; and 
‘‘(III) each option for renal replace-
ment therapy (including home and in-cen-
ter as well as vascular access options and 
transplantation); and 
‘‘(ii) to ensure that the individual has the 
opportunity to actively participate in the choice 
of therapy. 
‘‘(2) The term ‘qualified person’ means— 
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‘‘(A) a physician (as described in subsection 
(r)(1)); 
‘‘(B) an individual who— 
‘‘(i) is— 
‘‘(I) a registered nurse; 
‘‘(II) a registered dietitian or nutri-
tion professional (as defined in subsection 
(vv)(2)); 
‘‘(III) a clinical social worker (as de-
fined in subsection (hh)(1)); 
‘‘(IV) a physician assistant, nurse 
practitioner, or clinical nurse specialist (as 
those terms are defined in subsection 
(aa)(5)); or 
‘‘(V) a transplant coordinator; and 
‘‘(ii) meets such requirements related to 
experience and other qualifications that the 
Secretary finds necessary and appropriate for 
furnishing the services described in paragraph 
(1); or 
‘‘(C) a renal dialysis facility subject to the re-
quirements of section 1881(b)(1) with personnel 
who— 
‘‘(i) provide the services described in para-
graph (1); and 
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‘‘(ii) meet the requirements of subpara-
graph (A) or (B). 
‘‘(3) The Secretary shall develop the information to 
be provided under paragraph (1)(C)(i) and the require-
ments under (2)(B)(ii) after consulting with physicians, 
health educators, professional organizations, accrediting 
organizations, kidney patient organizations, dialysis facili-
ties, transplant centers, network organizations described 
in section 1881(c)(2), and other knowledgeable persons. 
‘‘(4) In promulgating regulations to carry out this 
subsection, the Secretary shall ensure that each bene-
ficiary who is entitled to kidney disease education services 
under this title receives such services in a timely manner 
to maximize the benefit of those services. 
‘‘(5) The Secretary shall monitor the implementation 
of this subsection to ensure that beneficiaries who are eli-
gible for kidney disease education services receive such 
services in the manner described in paragraph (4). 
‘‘(6) No individual shall be eligible to be provided 
more than 6 sessions of kidney disease education services 
under this title.’’. 
(3) PAYMENT
UNDER
THE
PHYSICIAN
FEE 
SCHEDULE.—Section 1848(j)(3) of the Social Secu-
rity Act (42 U.S.C. 1395w–4(j)(3)) is amended by 
inserting ‘‘(2)(BB),’’ after ‘‘(2)(AA),’’. 
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(4) PAYMENT
TO
RENAL
DIALYSIS
FACILI-
TIES.—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: 
‘‘(14) For purposes of paragraph (12), the sin-
gle composite weighted formulas determined under 
such paragraph shall not take into account the 
amount of payment for kidney disease education 
services (as defined in section 1861(ccc)). Instead, 
payment for such services shall be made to the renal 
dialysis facility on an assignment-related basis under 
section 1848.’’. 
(5) LIMITATION ON NUMBER OF SESSIONS.— 
Section 1862(a)(1) of the Social Security Act (42 
U.S.C. 1395y(a)(1)) is amended— 
(A) in subparagraph (M), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (N), by striking the 
semicolon at the end and inserting ‘‘, and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(O) in the case of kidney disease edu-
cation 
services 
(as 
defined 
in 
section 
1861(ccc)), which are performed in excess of 
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