Act (42 U.S.C. 1395rr(b)(14)), as amended by subsection 
(a), is amended by adding at the end the following new 
subparagraph: 
‘‘(K) Not later than January 1, 2022, the 
Secretary shall amend the ESRD facility cost 
report to include the per treatment network fee 
(as described in paragraph (7)) as an allowable 
cost or offset to revenue.’’. 
(c) DETERMINATION
OF PRODUCTIVITY ADJUST-
MENT.—Section 1886(b)(3)(B)(xi) of the Social Security 
Act (42 U.S.C. 1395ww(b)(3)(B)(xi)) is amended— 
(1) in subclause (I), by striking ‘‘For 2012’’ 
and inserting ‘‘Subject to subclause (IV), for 2012’’; 
and 
(2) by adding at the end, the following new sub-
clause: 
‘‘(IV) For each of 2022 through 
2025, the productivity adjustment de-
scribed in subclause (II) shall be zero 
for a payment system in any year in 
which the Medicare Payment Advisory 
Commission estimates that payments 
under this title pursuant to such pay-
ment system, on an aggregate na-
tional basis, exceed costs, on an ag-
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gregate national basis, by 3.0 percent 
or less.’’. 
(d) PAYMENT FOR NEW AND INNOVATIVE DRUGS 
AND BIOLOGICALS THAT ARE RENAL DIALYSIS SERV-
ICES.—Section 1881(b)(14) of the Social Security Act (42 
U.S.C. 1395ww(b)(14)), as amended by subsections (a) 
and (b), is amended by adding the following new subpara-
graph— 
‘‘(L) PAYMENT FOR NEW AND INNOVATIVE 
DRUGS, BIOLOGICALS, AND DEVICES THAT ARE 
RENAL DIALYSIS SERVICES.— 
‘‘(i) IN
GENERAL.—For drugs or 
biologicals determined to be within a func-
tional category, the Secretary, in consulta-
tion with stakeholders, shall ensure that 
the single payment amount is adequate to 
cover the cost of new innovative drugs or 
biologicals and increase the single payment 
amount if the Secretary determines such 
payment amount is not adequate to cover 
such cost. In carrying out the preceding 
sentence, the Secretary shall use the cost 
and utilization data collected during the 
three-year transitional payment period, as 
otherwise described in the final regulation 
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published on November 14, 2018 (83 Fed. 
Reg. 56922 et seq.). 
‘‘(ii) MONEY
TO
FOLLOW
THE
PA-
TIENT.—The Secretary, through notice 
and comment rulemaking, shall implement 
a policy for any drug or biological that is 
not provided to the ‘average’ patient that 
results in the amount by which the single 
payment amount is increased pursuant to 
this subparagraph shall be paid only when 
a provider or renal dialysis facility has 
demonstrated that it has administered the 
drug or biological to a patient.’’. 
(e) NEW DEVICES AND OTHER TECHNOLOGIES.—As 
part of the promulgation of the annual rule for the Medi-
care end-stage renal disease prospective payment system 
under section 1881(b)(14) of the Social Security Act (42 
U.S.C. 1395rr(b)(14)) for calendar year 2022, and in con-
sultation with stakeholders, the Secretary shall ensure 
that the single payment amount is adequate to cover the 
cost of the new innovative device or other technology with 
substantial clinical improvement and increase the single 
payment amount if the Secretary determines such pay-
ment amount is not adequate to cover such cost. In car-
rying out the preceding sentence, the Secretary shall use 
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the cost and utilization data collected during a three-year 
transitional payment period, as otherwise described in the 
final regulation published on November 9, 2020 (85 Fed. 
Reg. 71398 et seq.). 
TITLE III—INCREASING PATIENT 
ACCESS 
TO 
QUALITY 
PER-
FORMANCE 
BY 
IMPROVING 
THE ACCURACY AND TRANS-
PARENCY 
OF 
END-STAGE 
RENAL 
DISEASE 
QUALITY 
PROGRAMS 
SEC. 301. IMPROVING PATIENT DECISION MAKING AND 
TRANSPARENCY 
BY 
CONSOLIDATING 
AND 
MODERNIZING QUALITY PROGRAMS. 
(a) MEASURES.—Section 1881(h)(2) of the Social 
Security Act (42 U.S.C. 1395rr(h)(2)) is amended— 
(1) by striking subparagraph (A) and inserting 
the following: 
‘‘(A) The measures specified under this 
paragraph with respect to the year involved 
shall be selected by the Secretary in consulta-
tion with stakeholders to promote improvement 
in beneficiary outcomes and shared decision- 
making with beneficiaries and their caregivers. 
When selecting measures specified under this 
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paragraph, the Secretary shall take into ac-
count clinical gaps in care, underutilization that 
may lead to beneficiary harm, patient safety, 
and outcomes.’’; 
(2) in subparagraph (B)(i), by striking ‘‘sub-
paragraph (A)(iv)’’ and inserting ‘‘subparagraph 
(A)’’; 
(3) by striking subparagraph (E); and 
(4) by adding at the end the following new sub-
paragraphs: 
‘‘(E) WEIGHTING LIMITATION.—No single 
measure specified by the Secretary or individual 
measure within a composite measure so speci-
fied may be weighted less than 10 percent of 
the total performance score. 
‘‘(F) STATISTICALLY
VALID
AND
RELI-
ABLE.—In specifying measures under subpara-
graph (A), the Secretary shall only specify 
measures that have been shown to be statis-
tically valid and reliable through testing.’’. 
(b) ENDORSEMENT.—Section 1881(h)(2)(B) of the 
Social Security Act (42 U.S.C. 1395rr(h)(2)(B)) is 
amended— 
(1) in clause (ii), by adding at the end the fol-
lowing new sentence: ‘‘The exception under the pre-
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