‘‘(ii) meets such requirements related to 
experience and other qualifications that the 
Secretary finds necessary and appropriate for 
furnishing the services described in paragraph 
(1); or 
‘‘(C) a renal dialysis facility subject to the re-
quirements of section 1881(b)(1) with personnel 
who— 
‘‘(i) provide the services described in para-
graph (1); and 
‘‘(ii) meet the requirements of subpara-
graph (A) or (B). 
‘‘(3) The Secretary shall develop the requirements 
under paragraphs (1)(C)(i) and (2)(B)(ii) after consulting 
with physicians, health educators, professional organiza-
tions, accrediting organizations, kidney patient organiza-
tions, dialysis facilities, transplant centers, network orga-
nizations described in section 1881(c)(2), and other 
knowledgeable persons. 
‘‘(4) In promulgating regulations to carry out this 
subsection, the Secretary shall ensure that each bene-
ficiary who is entitled to kidney disease education services 
under this title receives such services in a timely manner 
to maximize the benefit of those services.
‘‘(5) The Secretary shall monitor the implementation 
of this subsection to ensure that beneficiaries who are eli-
gible for kidney disease education services receive such 
services in the manner described in paragraph (4). 
‘‘(6) No individual shall be eligible to be provided 
more than 6 sessions of kidney disease education services 
under this title.’’. 
(3) PAYMENT UNDER PHYSICIAN FEE SCHED-
ULE.—Section 1848(j)(3) of the Social Security Act 
(42 U.S.C. 1395w–4(j)(3)), as amended by section 
611(c) of the Medicare Prescription Drug, Improve-
ment, and Modernization Act of 2003 (Public Law 
108–173; 117 Stat. 2304), is amended by inserting 
‘‘(2)(AA),’’ after ‘‘(2)(W),’’. 
(4) PAYMENT
TO
RENAL
DIALYSIS
FACILI-
TIES.—Section 1881(b) of the Social Security Act 
(42 U.S.C. 1395rr(b)), as amended by section 2(b), 
is amended by adding at the end the following new 
paragraph: 
‘‘(15) For purposes of paragraph (12), the sin-
gle composite weighted formulas determined under 
such paragraph shall not take into account the 
amount of payment for kidney disease education 
services (as defined in section 1861(bbb)). Instead, 
payment for such services shall be made to the renal
dialysis facility on an assignment-related basis under 
section 1848.’’. 
(5) LIMITATION ON NUMBER OF SESSIONS.— 
Section 1862(a)(1) of the Social Security Act (42 
U.S.C. 1395y(a)(1)), as amended by section 613(c) 
of the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 (Public Law 108– 
173; 117 Stat. 2306), is amended— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (L); 
(B) by striking the semicolon at the end of 
subparagraph (M) and inserting ‘‘, and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(N) in the case of kidney disease education 
services (as defined in section 1861(bbb)), which are 
performed in excess of the number of sessions cov-
ered under such section;’’. 
(6) ANNUAL REPORT TO CONGRESS.—Not later 
than April 1, 2005, and annually thereafter, the 
Secretary of Health and Human Services (in this 
section referred to as the ‘‘Secretary’’) shall submit 
to Congress a report on the number of medicare 
beneficiaries who are entitled to kidney disease edu-
cation services (as defined in section 1861(bbb) of
the Social Security Act, as added by paragraph (1)) 
under title XVIII of such Act and who receive such 
services, together with such recommendations for 
legislative and administrative action as the Secretary 
determines to be appropriate to fulfill the legislative 
intent that resulted in the enactment of that sub-
section. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on and after 
January 1, 2006. 
SEC. 203. BLOOD FLOW MONITORING DEMONSTRATION 
PROJECTS. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall establish demonstration projects to evaluate 
how blood flow monitoring affects the quality and cost of 
care for medicare beneficiaries with end-stage renal dis-
ease. 
(b) DURATION.—The demonstration projects under 
this section shall be conducted for a period of not longer 
than 5 years that begins on January 1, 2006. 
(c) EVALUATION AND REPORT.— 
(1) EVALUATION.—The Secretary shall conduct 
an evaluation of the demonstration projects con-
ducted under this section.