I 
110TH CONGRESS 
1ST SESSION H. R. 1245 
To amend title XVIII of the Social Security Act to provide coverage for 
kidney disease education services under the Medicare Program, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 28, 2007 
Mr. KIRK (for himself and Mr. MCDERMOTT) 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 subse-
quently 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 
coverage for kidney disease education services under the 
Medicare Program, and for other purposes. 
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 ‘‘Kidney Disease Edu-
cational Benefits Act of 2007’’. 
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SEC. 2. MEDICARE COVERAGE OF KIDNEY DISEASE EDU-
CATION SERVICES. 
(a) COVERAGE
OF KIDNEY DISEASE EDUCATION 
SERVICES.— 
(1) IN GENERAL.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x) is amended— 
(A) in subsection (s)(2)— 
(i) in subparagraph (Z), by striking 
‘‘and’’ at the end; 
(ii) in subparagraph (AA), by adding 
‘‘and’’ at the end; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(BB) kidney disease education services (as de-
fined in subsection (ccc));’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(ccc) KIDNEY DISEASE EDUCATION SERVICES.—(1) 
The term ‘kidney disease education services’ means edu-
cational 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; 
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‘‘(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— 
‘‘(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)); 
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‘‘(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 
‘‘(ii) meet the requirements of subpara-
graph (A) or (B). 
‘‘(3) The Secretary shall develop the requirements 
under paragraph (2)(B)(ii) after consulting with physi-
cians, health educators, professional organizations, accred-
iting organizations, kidney patient organizations, dialysis 
facilities, transplant centers, network organizations de-
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scribed 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 
that ensures that the beneficiary receives the maximum 
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.’’. 
(2) PAYMENT UNDER PHYSICIAN FEE SCHED-
ULE.—Section 1848(j)(3) of the Social Security Act 
(42 U.S.C. 1395w–4(j)(3)) is amended by inserting 
‘‘(2)(BB),’’, after ‘‘(2)(AA),’’. 
(3) 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 
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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.’’. 
(4) LIMITATION ON NUMBER OF SESSIONS.— 
Section 1862(a)(1) of the Social Security Act (42 
U.S.C. 1395y(a)(1)) is amended— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (M); 
(B) by striking the semicolon at the end of 
subparagraph (N) and inserting ‘‘, and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(O) in the case of kidney disease education 
services (as defined in section 1861(ccc)), which are 
performed in excess of the number of sessions cov-
ered under such section;’’. 
(5) ANNUAL REPORT TO CONGRESS.—Not later 
than April 1, 2008, and annually thereafter, the 
Secretary of Health and Human Services shall sub-
mit to Congress a report on the number of medicare 
beneficiaries who are entitled to kidney disease edu-
cation services (as defined in section 1861(ccc) of 
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the Social Security Act, as added by paragraph (1)) 
under title XVIII of such Act and who receive such 
services, together with such recommendations for 
legislative and administrative action as the Secretary 
determines to be appropriate to fulfill the legislative 
intent that resulted in the enactment of that sub-
section. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2008. 
Æ 
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