I 
119TH CONGRESS 
1ST SESSION H. R. 2199 
To amend title XVIII of the Social Security Act to clarify and preserve 
the breadth of the protections under the Medicare Secondary Payer Act. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 18, 2025 
Mr. KELLY of Pennsylvania (for himself, Ms. CLARKE of New York, Mr. 
DUNN of Florida, Mr. DAVIS of Illinois, Mr. JOYCE of Pennsylvania, and 
Mr. RUIZ) introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to clarify 
and preserve the breadth of the protections under the 
Medicare Secondary Payer Act. 
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 ‘‘Restore Protections 
for Dialysis Patients Act’’. 
SEC. 2. PURPOSES. 
The purposes of this Act are the following: 
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(1) To restore the MSPA’s protections for 
ESRD patients by ensuring that private health plans 
do not discriminate against such patients or ad-
versely classify dialysis as compared to other covered 
medical services. 
(2) To prohibit health insurance plans from 
shifting primary responsibility for covering the cost 
of health care services needed by patients with 
ESRD to the Medicare program. 
(3) To affirm Congress’ intent by clarifying 
that singling out dialysis services for disfavored 
treatment through coverage limitations as compared 
to other covered health services constitutes inappro-
priate differentiations between the benefits provided 
to individuals having ESRD and other individuals, 
but does not change a plan’s current ability to limit 
which renal dialysis providers it includes in the pro-
vider network it elects to offer its enrollees. 
SEC. 3. CLARIFICATION AND PRESERVATION OF PROHIBI-
TION UNDER THE MEDICARE PROGRAM. 
Section 1862(b)(1)(C) of the Social Security Act (42 
U.S.C. 1395y(b)(1)(C)) is amended— 
(1) by striking clause (ii) and inserting the fol-
lowing new clause: 
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‘‘(ii) may not on any basis (including 
the diagnosis of end stage renal disease or 
the need for renal dialysis) or in any man-
ner— 
‘‘(I) differentiate (or have the ef-
fect of differentiating) in the benefits 
it provides between individuals having 
end stage renal disease and other in-
dividuals covered by such plan; or 
‘‘(II) apply a limitation on bene-
fits (including on network composi-
tion) under the plan that will dispar-
ately affect individuals having end 
stage renal disease;’’; and 
(2) by adding at the end of the matter following 
clause (ii) the following new sentences: ‘‘Nothing in 
this subsection shall be construed as requiring a 
group health plan to include a particular renal dialy-
sis provider or a particular number of renal dialysis 
providers as part of the provider network the group 
health plan elects to offer its enrollees. The Sec-
retary shall enforce this subparagraph consistent 
with the nonconformance determination require-
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ments set forth in part 411 of title 42, Code of Fed-
eral Regulations.’’. 
Æ 
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