status under section 1862(b)(1)(C) of the Social Security 
Act (42 U.S.C. 1395y(b)(1)(C)), as amended by sub-
section (a), an individual who is within the coordinating 
period as of the date of enactment of this Act shall have 
that period extended to the full 42 months described in 
the last sentence of such section, as added by the amend-
ment made by subsection (a)(2). 
SEC. 303. PROVIDING INDIVIDUALS WITH KIDNEY FAILURE 
ACCESS TO MANAGED CARE AND COORDI-
NATED CARE PROGRAMS. 
(a) EXPANDING ACCESS
TO MEDICARE ADVAN-
TAGE.— 
(1) ELIGIBILITY
UNDER
MEDICARE
ADVAN-
TAGE.— 
(A) IN GENERAL.—Section 1851(a)(3) of 
the Social Security Act (42 U.S.C. 1395w– 
21(a)(3)) is amended— 
(i) by striking subparagraph (B); and 
(ii) by striking ‘‘ELIGIBLE
INDI-
VIDUAL.—’’ and all that follows through 
‘‘In this title’’ and inserting ‘‘ELIGIBLE IN-
DIVIDUAL.—In this title’’. 
(B) CONFORMING
AMENDMENT.—Section 
1852(b)(1) of the Social Security Act (42 
U.S.C. 1395w–22(b)(1)) is amended— 
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(i) by striking subparagraph (B); and 
(ii) by striking ‘‘BENEFICIARIES.—’’ 
and 
all 
that 
follows 
through 
‘‘A 
Medicare+Choice organization’’ and in-
serting ‘‘BENEFICIARIES.—A Medicare Ad-
vantage organization’’. 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply with respect 
to plan years beginning on or after January 1, 
2016. 
(2) EDUCATION.—Section 1851(d)(2)(A)(iii) of 
the Social Security Act (42 U.S.C. 1395w– 
21(d)(2)(A)(iii)) is amended by inserting before the 
period at the end the following ‘‘, including any ad-
ditional information that individuals determined to 
have end stage renal disease may need to make in-
formed decisions with respect to such an election’’. 
(3) QUALITY METRICS.—Section 1852(e)(3)(A) 
of the Social Security Act (42 U.S.C. 1395w– 
22(e)(3)(A)) is amended by adding at the end the 
following new clause: 
‘‘(v) REQUIREMENTS WITH RESPECT 
TO INDIVIDUALS WITH ESRD.—In addition 
to the data required to be collected, ana-
lyzed, and reported under clause (i) and 
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notwithstanding the limitations under sub-
paragraph (B), as part of the quality im-
provement program under paragraph (1), 
each MA organization shall provide for the 
collection, analysis, and reporting of data, 
determined in consultation with the kidney 
care community, that permits the measure-
ment of health outcomes and other indices 
of quality with respect to individuals deter-
mined to have end stage renal disease.’’. 
(b) PERMANENT EXTENSION OF MEDICARE ADVAN-
TAGE ESRD SPECIAL NEEDS PLANS AUTHORITY.—Sec-
tion 1859(f)(1) of the Social Security Act (42 U.S.C. 
1395w–28(f)(1)) is amended by inserting ‘‘, in the case 
of a specialized MA plan for special needs individuals who 
have not been determined to have end stage renal dis-
ease,’’ before ‘‘for periods before January 1, 2017’’. 
(c) 
VOLUNTARY
ESRD 
COORDINATED
CARE 
GAINSHARING PROGRAM.— 
(1) IN GENERAL.—Section 1881(b) of the So-
cial Security Act (42 U.S.C. 1395rr(b)) is amended 
by adding at the end the following new paragraph: 
‘‘(15)(A) Not later than January 1, 2017, the Sec-
retary shall, in accordance with this paragraph, establish 
an ESRD Care Coordination gainsharing program for 
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nephrologists, renal dialysis facilities, and providers of 
services that develop coordinated care organizations to 
provide a full range of clinical and supportive services (as 
described in subparagraph (D)) to individuals determined 
to have end stage renal disease. 
‘‘(B) Under such program, subject to subparagraph 
(C), the payment amounts renal dialysis facilities and pro-
viders of services described in subparagraph (A) would 
otherwise receive under paragraph (14) and nephrologists 
described in subparagraph (A) would otherwise receive 
under section 1848 with respect to dialysis services fur-
nished by such a facility, provider, or nephrologist during 
a year, shall be increased by a portion of the amount (as 
determined by the Secretary) of actual reductions in ex-
penditure under this title attributable to the coordinated 
care organization developed by such facility, provider, or 
nephrologist involved, taking into account non-dialysis ex-
penditures under parts A and B, during the preceding cal-
endar year. The payment amount under this subparagraph 
shall be provided to a nephrologist, renal dialysis facility, 
and provider of services that developed the coordinated 
care organization no later than March 31 of the year after 
the year during which such services are provided by such 
nephrologist, facility, or provider. 
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‘‘(C) The aggregate incentive payment amounts pro-
vided under such program for a year may not exceed the 
amount equal to 2 percent less than the estimated total 
amount of non-dialysis expenditures under parts A and 
B for 2016 for items and services that are not related 
to dialysis or transplant services. 
‘‘(D) For purposes of subparagraph (A), the full 
range of clinical and supportive services includes at least 
the following: 
‘‘(i) Primary care and other preventative serv-
ices. 
‘‘(ii) Specialty care for co-morbidities or non- 
renal acute conditions, including at least podiatry, 
cardiology, and orthopedics. 
‘‘(iii) Vascular access. 
‘‘(iv) Laboratory testing and diagnostic imag-
ing. 
‘‘(v) Pharmacy care management. 
‘‘(vi) Patient, family, and caregiver education. 
‘‘(vii) Psychiatric, behavioral therapy, and coun-
seling services. 
‘‘(E) In providing payment incentive amounts under 
such program, the Secretary shall apply a risk adjustment 
methodology that— 
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