I 
114TH CONGRESS 
2D SESSION 
H. R. 5659 
To amend title XVIII of the Social Security Act with respect to expanding 
Medicare Advantage coverage for individuals with end-stage renal disease 
(ESRD). 
IN THE HOUSE OF REPRESENTATIVES 
JULY 7, 2016 
Mr. SMITH of Missouri (for himself, Mr. LEWIS, Mr. BILIRAKIS, Mr. SCHRA-
DER, and Mr. MARINO) introduced the following bill; which was referred 
to the Committee on Ways and Means, and in addition to the Committee 
on Energy and Commerce, for a period to be subsequently determined by 
the Speaker, in each case for consideration of such provisions as fall with-
in the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act with respect 
to expanding Medicare Advantage coverage for individ-
uals with end-stage renal disease (ESRD). 
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 ‘‘Expanding Seniors Re-
ceiving Dialysis Choice Act of 2016’’ or as the ‘‘ESRD 
Choice Act of 2016’’. 
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SEC. 2. EXPANDING MEDICARE ADVANTAGE COVERAGE 
FOR INDIVIDUALS WITH END-STAGE RENAL 
DISEASE (ESRD). 
(a) EXPANDED MA ELIGIBILITY.— 
(1) IN GENERAL.—Section 1851(a)(3) of the 
Social Security Act (42 U.S.C. 1395w–21(a)(3)) is 
amended— 
(A) by striking subparagraph (B); and 
(B) by striking ‘‘ELIGIBLE
INDIVIDUAL’’ 
and all that follows through ‘‘In this title, sub-
ject to subparagraph (B),’’ and inserting ‘‘ELI-
GIBLE INDIVIDUAL.—In this title,’’. 
(2) CONFORMING AMENDMENTS.— 
(A) Section 1852(b)(1) of the Social Secu-
rity Act (42 U.S.C. 1395w–22(b)(1)) is amend-
ed— 
(i) by striking subparagraph (B); and 
(ii) by striking ‘‘BENEFICIARIES’’ and 
all 
that 
follows 
through 
‘‘A 
Medicare+Choice organization’’ and in-
serting ‘‘BENEFICIARIES.—A Medicare Ad-
vantage organization.’’. 
(B) The flush sentence at the end of sec-
tion 1859(b)(6) of the Social Security Act (42 
U.S.C. 1395w–28(b)(6)) is amended by striking 
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‘‘may waive’’ and all that follows through ‘‘sub-
paragraph and’’. 
(b) EXCLUDING COSTS FOR KIDNEY ACQUISITIONS 
FROM MA BENCHMARK.—Section 1853 of the Social Se-
curity Act (42 U.S.C. 1395w–23) is amended— 
(1) in subsection (k)— 
(A) in paragraph (1)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘paragraphs (2) 
and (4)’’ and inserting ‘‘paragraphs (2), 
(4), and (5)’’; and 
(ii) in subparagraph (B)(i), by strik-
ing ‘‘paragraphs (2) and (4)’’ and insert-
ing ‘‘paragraphs (2), (4), and (5)’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(5) EXCLUSION OF COSTS FOR KIDNEY ACQUI-
SITIONS
FROM
CAPITATION
RATES.—After deter-
mining the applicable amount for an area for a year 
under paragraph (1) (beginning with 2019), the Sec-
retary shall adjust such applicable amount to ex-
clude from such applicable amount the Secretary’s 
estimate of the standardized costs for payments for 
organ acquisitions for kidney transplants covered 
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