(2) REPORT.—Not later than 6 months after 
the date on which the demonstration projects under 
this section are completed, the Secretary shall sub-
mit to Congress a report on the evaluation con-
ducted under paragraph (1) together with rec-
ommendations for such legislation and administra-
tive action as the Secretary determines appropriate. 
(d) WAIVER AUTHORITY.—The Secretary shall waive 
compliance with the requirements of title XVIII of the So-
cial Security Act (42 U.S.C. 1395 et seq.) to such extent 
and for such period as the Secretary determines is nec-
essary to conduct the demonstration projects. 
(e) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—Payments for the costs of 
carrying out the demonstration project under this 
section shall be made from the Federal Supple-
mentary Medical Insurance Trust Fund under sec-
tion 1841 of such Act (42 U.S.C. 1395t). 
(2) AMOUNT.—There are authorized to be ap-
propriated from such Trust Fund $1,000,000 for 
each of fiscal years 2006 through 2010 to carry out 
this section.
TITLE III—FINANCING AND 
COVERAGE FOR ESRD PATIENTS 
SEC. 301. IMPROVING THE HOME DIALYSIS BENEFIT. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall provide appropriate incentives to improve 
the home dialysis benefit for individuals on behalf of whom 
payment may be made under section 1881 of the Social 
Security Act (42 U.S.C. 1395rr). 
(b) CONSIDERATIONS.—In developing the incentives 
under subsection (a), the Secretary shall consider revising 
the fee schedule for physicians’ services under section 
1848 of the Social Security Act (42 U.S.C. 1395w–4) so 
that the amount paid for services related to end-stage 
renal disease furnished to home dialysis patients is equal 
to the amount paid for services related to end-stage renal 
disease furnished to other patients with 4 or more face- 
to-face physician visits per month. 
SEC. 302. INSTITUTE OF MEDICINE EVALUATION AND RE-
PORT ON HOME DIALYSIS. 
(a) EVALUATION.— 
(1) IN GENERAL.—Not later than the date that 
is 2 months after the date of enactment of this Act, 
the Secretary of Health and Human Services (in this 
section referred to as the ‘‘Secretary’’) shall enter
into an arrangement under which the Institute of 
Medicine of the National Academy of Sciences (in 
this section referred to as the ‘‘Institute’’) shall con-
duct an evaluation of the barriers that exist to in-
creasing the number of individuals with end-stage 
renal disease who elect to receive home dialysis serv-
ices under the medicare program under title XVIII 
of the Social Security Act (42 U.S.C. 1395 et seq.). 
(2) SPECIFIC MATTERS EVALUATED.—In con-
ducting the evaluation under paragraph (1), the In-
stitute shall— 
(A) compare current medicare home dialy-
sis payments with current in-center and hos-
pital dialysis payments; 
(B) catalogue and evaluate the incentives 
and disincentives in the current reimbursement 
system that influence whether patients receive 
home dialysis services; 
(C) evaluate patient education services and 
how such services impact the treatment choices 
made by patients; and 
(D) consider such other matters as the In-
stitute determines appropriate. 
(3) SCOPE
OF
REVIEW.—The Institute shall 
consider a variety of perspectives, including the per-