‘‘(II) The term ‘qualified provider’ 
means a trained professional (as deter-
mined by the Secretary, including nurses 
and certified patient technicians) who fur-
nishes renal dialysis services and— 
‘‘(aa) meets requirements (as de-
termined by the Secretary) that en-
sures competency in patient care and 
modality usage; and 
‘‘(bb) provides in-person assist-
ance to a patient for at least 75 per-
cent of staff-assisted home dialysis 
sessions during a period described in 
clause (ii)(i). 
‘‘(III)(aa) The term ‘staff-assisted 
home dialysis’ means home dialysis using 
trained professionals to assist individuals 
who have been determined to have end 
stage renal disease, and the frequency of 
such home dialysis is determined by such 
professionals in coordination with the pa-
tient and his or her care partner, and out-
lined in a patient plan of care. 
‘‘(bb) In this subclause, the term ‘care 
partner’ means anyone who is designated 
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by the patient who assists the individual 
with the furnishing of home dialysis. 
‘‘(cc) In this subclause, the term ‘pa-
tient plan of care’ has the meaning given 
such term in section 494.90 of title 42, 
Code of Federal Regulations.’’. 
(b) PATIENT EDUCATION AND TRAINING RELATING 
TO
STAFF-ASSISTED
HOME
DIALYSIS.—Section 
1881(b)(5) of the Social Security Act (42 U.S.C. 
1395rr(b)(5)) is amended— 
(1) in subparagraph (C), by striking at the end 
‘‘and’’; 
(2) in subparagraph (D), by striking the period 
at the end and inserting a semicolon; and 
(3) by adding at the end the following new sub-
paragraphs: 
‘‘(D) educate patients of the opportunity to 
receive staff-assisted home dialysis (as defined 
in paragraph (14)(J)(iv)(III)) during the period 
beginning 30 days after the first day such facil-
ity furnishes renal dialysis services to an indi-
vidual and ending 60 days after such day; and 
‘‘(E) provide for nurses, certified patient 
technicians, or other professionals to train pa-
tients and their care partners in skills and pro-
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cedures needed to perform home dialysis (as de-
fined in paragraph (14)(J)(iv)(III)) treat-
ment— 
‘‘(i) regularly and independently; 
‘‘(ii) through telehealth services or 
through group training (as described in the 
interpretive guidance relating to tag num-
ber V590 of ‘Advance Copy—End Stage 
Renal Disease (ESRD) Program Interpre-
tive Guidance Version 1.1’ (published on 
October 3, 2008)) in accordance with the 
Federal regulations (concerning the privacy 
of individually identifiable health informa-
tion) promulgated under section 264(c) of 
the Health Insurance Portability and Ac-
countability Act of 1996; and 
‘‘(iii) in the home or resident of a pa-
tient, in a dialysis facility, or the place in 
which the patient intends to receive staff- 
assisted home dialysis.’’. 
(c) OTHER PROVISIONS.— 
(1) 
ANTI-KICKBACK
STATUTE.—Section 
1128B(b)(3) of the Social Security Act (42 U.S.C. 
1320a–7b(b)(3)) is amended— 
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(A) in subparagraph (J), by striking at the 
end ‘‘and’’; 
(B) in subparagraph (K), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(L) any remuneration relating to the fur-
nishing of staff-assisted home dialysis (as de-
fined in section 1881(b)(14)(J)(iv)(III)).’’. 
(2) CMI MODEL.—Section 1115A(b)(2)(B) of 
the Social Security Act (42 U.S.C. 1320b–(b)(2)(B)) 
is amended by adding at the end the following new 
clause: 
‘‘(xxviii) Making payment to anyone 
who is designated by a patient who re-
ceives staff-assisted home dialysis (as de-
fined in section 1881(b)(14)(J)(iv)(III)) 
and otherwise meets the requirements (as 
determined by the Secretary), notwith-
standing whether an individual is a quali-
fied 
provider 
(as 
defined 
in 
section 
1881(b)(14)(J)(iv)(II)) or otherwise eligi-
ble for reimbursement under title XVIII.’’. 
(3) STUDY.—Not later than 2 years after the 
date of the enactment of this Act, the Secretary of 
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Health and Human Services shall submit to the 
Committee on Energy and Commerce of the House 
of Representatives and the Committee on Finance of 
the Senate a report that examines racial disparities 
in the utilization of the home dialysis defined in sec-
tion 1881(b)(14)(J)(iv)(III) of the Social Security 
Act (42 U.S.C. 1395rr(b)(14)(J)(iv)(III)) and make 
recommendations on how to improve access to such 
dialysis for communities of color. 
(4) PATIENT DECISION TOOL.—Not later than 
December 31, 2023, for the purpose of section 
1881(b)(14)(J) of the Social Security Act (42 
U.S.C. 1395rr(b)(14)(J)), the Secretary of Health 
and Human Services shall convene a patient panel 
to create a patient-centered decision tool for dialysis 
patients to evaluate their lifestyle and goals and be 
assisted in choosing the dialysis modality that best 
suits them. This tool should include an acknowledg-
ment that they are capable of home dialysis and 
want home dialysis, if that is the modality they 
choose. 
(5) PATIENT QUALITY OF LIFE METRIC.—Sec-
tion 1115A(b)(2)(B) of the Social Security Act (42 
U.S.C. 1315a(b)(2)(B)) is amended by adding at the 
end the following new subparagraph: 
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‘‘(i) A patient quality of life metric for 
all patients utilizing dialysis regardless of 
modality with the intent of measuring and 
improving patient quality of life on dialy-
sis.’’. 
Æ 
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