I 
109TH CONGRESS 
1ST SESSION H. R. 3096 
To amend title XVIII of the Social Security Act to provide for payment 
under the Medicare Program for more frequent hemodialysis treatments. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 28, 2005 
Mr. MCDERMOTT (for himself, Ms. HART, Mr. RANGEL, Mr. KIRK, Mr. 
DICKS, Mr. SMITH of Washington, Mr. MCNULTY, Mr. HASTINGS of 
Washington, Mr. SCHIFF, Mr. KILDEE, Mr. GOODLATTE, Mr. LEWIS of 
Georgia, Mr. INSLEE, Ms. JACKSON-LEE of Texas, Ms. BORDALLO, Mr. 
WEXLER, Mr. SANDERS, Mr. OWENS, and Mr. BRADY of Pennsylvania) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for payment under the Medicare Program for more fre-
quent hemodialysis treatments. 
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 Patient More 
Frequent Dialysis Quality Act of 2005’’.
SEC. 1. COVERAGE OF MORE FREQUENT HEMODIALYSIS 
TREATMENTS. 
(a) IN GENERAL.—Section 1881(b) of the Social Se-
curity Act (42 U.S.C. 1395rr(b)) is amended— 
(1) in paragraph (12)(B)— 
(A) by striking ‘‘and’’ at the end of clause 
(i); 
(B) by striking the period at the end of 
clause (ii) and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(iii) more frequent hemodialysis furnished to 
qualified individuals under paragraph (14).’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(14)(A). Not later than the date that is 1 year after 
the date of enactment of this paragraph, the Secretary 
shall cause to have published in the Federal Register final 
regulations for equivalent per treatment prospective pay-
ment rates for more frequent hemodialysis furnished at 
home and furnished in a facility (commonly known as com-
posite ‘Method I’ rates and ‘Method II Cap’ payment 
rates), and prospective payment rates for in-facility train-
ing for more frequent hemodialysis.
‘‘(B) In developing per treatment prospective pay-
ment rates under subparagraph (A), the Secretary shall 
consider— 
‘‘(i) actual reasonable costs of operating more 
frequent hemodialysis programs; and 
‘‘(ii) data from the Centers for Medicare & 
Medicaid Services on actual expenditures under this 
title for more frequent hemodialysis patients, com-
pared to— 
‘‘(I) data on expenditures for the same pa-
tients before those patients underwent more fre-
quent hemodialysis, and 
‘‘(II) data on expenditures for patients un-
dergoing hemodialysis treatment 3 times per 
week with similar clinical and demographic 
characteristics. 
‘‘(C) Not later than 1 year after the date of enact-
ment of this paragraph, the Secretary shall develop, in 
consultation with the renal community, a standard of care 
and quality standards for more frequent hemodialysis. The 
Secretary shall periodically review and update as necessary 
such standards. 
‘‘(D) The Secretary shall collect data with respect 
to—
‘‘(i) documented savings in expenditures under 
this title by reason of more frequent hemodialysis 
that are attributable to reduced medications, hos-
pitalizations, outpatient services, and such other fac-
tors as the Secretary determines appropriate; and 
‘‘(ii) the improved quality of care and improved 
outcomes more frequent hemodialysis may bring to 
patients. 
‘‘(E) In this paragraph: 
‘‘(i) The term ‘more frequent hemodialysis’ 
means hemodialysis treatment sessions, or equivalent 
therapy requiring blood access, performed 4 or 5 
times per week. 
‘‘(ii) The term ‘qualified individual’ means an 
individual who, in the clinical judgment of the physi-
cian of the individual, is likely to achieve better clin-
ical outcomes, quality of life outcomes, or both from 
more frequent hemodialysis.’’. 
(b) 
CONFORMING
AMENDMENTS.—(1) 
Section 
1881(b)(8) of the Social Security Act (42 U.S.C. 
1395rr(b)(8)) is amended by inserting ‘‘and more frequent 
hemodialysis supplies and equipment’’ after ‘‘home dialy-
sis supplies and equipment’’. 
(2) Section 1881(b)(9) of such Act (42 U.S.C. 
1395rr(b)(9)) is amended by inserting ‘‘and more frequent
hemodialysis support services’’ after ‘‘self-care home dialy-
sis support services’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of the enactment 
of this Act and shall apply with respect to items and serv-
ices furnished on or after the date that is 1 year after 
such date of enactment. 
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