I 
115TH CONGRESS 
1ST SESSION H. R. 3164 
To amend title XVIII of the Social Security Act to expand access to home 
dialysis therapy. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 6, 2017 
Mrs. BLACK (for herself, Ms. DELBENE, Mr. THOMPSON of California, and 
Mr. MEEHAN) 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 subsequently 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 expand 
access to home dialysis therapy. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. EXPANDING ACCESS TO HOME DIALYSIS THER-
APY. 
(a) ALLOWING USE OF TELEHEALTH FOR MONTHLY 
END STAGE RENAL DISEASE-RELATED VISITS.— 
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(1) IN
GENERAL.—Paragraph (3) of section 
1881(b) of the Social Security Act (42 U.S.C. 
1395rr(b)) is amended— 
(A) by redesignating subparagraphs (A) 
and (B) as clauses (i) and (ii), respectively; 
(B) in clause (ii), as redesignated by sub-
paragraph (A)— 
(i) by inserting ‘‘subject to subpara-
graph (B),’’ before ‘‘on a comprehensive’’; 
and 
(ii) by striking ‘‘under this subpara-
graph’’ and inserting ‘‘under this clause’’; 
(C) by striking ‘‘With respect to’’ and in-
serting ‘‘(A) With respect to’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(B)(i) Subject to clause (ii), an individual who is 
determined to have end stage renal disease and who is re-
ceiving home dialysis may choose to receive monthly end 
stage renal disease-related visits, furnished on or after 
January 1, 2019, via telehealth. 
‘‘(ii) Clause (i) shall apply to an individual only if 
the individual receives a face-to-face visit, without the use 
of telehealth— 
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‘‘(I) in the case of the initial three months of 
home dialysis of such individual, at least monthly; 
and 
‘‘(II) after such initial three months, at least 
once every three consecutive months.’’. 
(2) CONFORMING AMENDMENT.—Paragraph (1) 
of such section is amended by striking ‘‘paragraph 
(3)(A)’’ and inserting ‘‘paragraph (3)(A)(i)’’. 
(b) EXPANDING ORIGINATING SITES
FOR TELE-
HEALTH TO INCLUDE RENAL DIALYSIS FACILITIES AND 
THE HOME FOR PURPOSES OF MONTHLY END STAGE 
RENAL DISEASE-RELATED VISITS.— 
(1) IN GENERAL.—Section 1834(m) of the So-
cial Security Act (42 U.S.C. 1395m(m)) is amend-
ed— 
(A) in paragraph (4)(C)(ii), by adding at 
the end the following new subclauses: 
‘‘(IX) A renal dialysis facility, 
but only for purposes of section 
1881(b)(3)(B). 
‘‘(X) The home of an individual, 
but only for purposes of section 
1881(b)(3)(B).’’; and 
(B) by adding at the end the following new 
paragraph: 
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‘‘(5) TREATMENT OF HOME DIALYSIS MONTHLY 
ESRD-RELATED
VISIT.—The geographic require-
ments described in paragraph (4)(C)(i) shall not 
apply with respect to telehealth services furnished on 
or after January 1, 2019, for purposes of section 
1881(b)(3)(B), at an originating site described in 
subclause 
(VI), 
(IX), 
or 
(X) 
of 
paragraph 
(4)(C)(ii)).’’. 
(2) NO
FACILITY
FEE
IF
ORIGINATING
SITE 
FOR HOME DIALYSIS THERAPY IS THE HOME.—Sec-
tion 1834(m)(2)(B) of the Social Security (42 
U.S.C. 1395m(m)(2)(B)) is amended— 
(A) by redesignating clauses (i) and (ii) as 
subclauses (I) and (II), respectively, and by in-
denting each of such subclauses 2 ems to the 
right; 
(B) in subclause (II), as redesignated by 
subparagraph (A), by striking ‘‘clause (i) or 
this clause’’ and inserting ‘‘subclause (I) or this 
subclause’’; 
(C) by striking ‘‘SITE.—With respect to’’ 
and inserting ‘‘SITE.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), with respect to’’; and 
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(D) by adding at the end the following new 
clause: 
‘‘(ii) NO
FACILITY
FEE
IF
ORIGI-
NATING SITE FOR HOME DIALYSIS THER-
APY IS THE HOME.—No facility fee shall 
be paid under this subparagraph to an 
originating site described in subclause (X) 
of paragraph (4)(C)(ii).’’. 
(c) CLARIFICATION REGARDING TELEHEALTH PRO-
VIDED TO BENEFICIARIES.—Section 1128A(i)(6) of the 
Social Security Act (42 U.S.C. 1320a–7a(i)(6)) is amend-
ed— 
(1) in subparagraph (H), by striking ‘‘; or’’ and 
inserting a semicolon; 
(2) in subparagraph (I), by striking the period 
at the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(J) the provision of telehealth on or after 
January 1, 2019, to individuals with end stage 
renal disease under title XVIII by a health care 
provider for the purpose of furnishing of tele-
health.’’. 
(d) STUDY
AND REPORT
ON FURTHER EXPAN-
SION.— 
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(1) STUDY.—The Comptroller General of the 
United States shall conduct a study to examine the 
benefits and drawbacks of expanding the coverage 
under the Medicare program under title XVIII of 
the Social Security Act of renal dialysis services as 
telehealth services, pursuant to the amendments 
made by this section, to include coverage of renal di-
alysis services furnished via telehealth and other 
store-and-forward technologies. 
(2) REPORT.—Not later than two years after 
the date of the enactment of this Act, the Comp-
troller General shall submit to Congress a report on 
the results of the study conducted under paragraph 
(1). 
Æ 
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