I 
117TH CONGRESS 
2D SESSION 
H. R. 7506 
To amend the Public Health Service Act with respect to preventing end- 
stage kidney disease, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 14, 2022 
Mr. BUTTERFIELD (for himself and Mr. BILIRAKIS) 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 sub-
sequently 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 the Public Health Service Act with respect to 
preventing end-stage kidney disease, and for other purposes. 
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 ‘‘New Era of Preventing 
End-Stage Kidney Disease Act’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents of this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
Sec. 3. Findings. 
Sec. 4. Definitions. 
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TITLE I—CENTERS OF EXCELLENCE AND RARE KIDNEY 
DISEASE RESEARCH 
Sec. 101. NIDDK Centers on Rare Kidney Disease Research. 
Sec. 102. Rare kidney disease progression research. 
TITLE II—DIAGNOSTICS 
Sec. 201. Diagnostic issues relating to rare kidney disease. 
TITLE III—COMMUNITIES OF COLOR 
Sec. 301. Understanding and slowing the progression of rare kidney disease 
and treatment in certain populations. 
Sec. 302. Communities of color service program. 
Sec. 303. NIH report on NIH research programs. 
Sec. 304. Partnerships with organizations and agencies. 
TITLE IV—PROVIDER EDUCATION 
Sec. 401. Primary care provider training grant program. 
Sec. 402. Grant program for development and implementation of curricula for 
continuing education on kidney disease. 
TITLE V—COVERAGE AND EXPERIMENTS TO REDUCE DIALYSIS 
AND TRANSPLANT COSTS 
Sec. 501. Medical expertise in pharmacy and therapeutic committees. 
Sec. 502. Reducing dialysis and transplant costs related to rare kidney disease. 
SEC. 3. FINDINGS. 
Congress finds the following: 
(1) Approximately 37,000,000 adults in the 
United States have a chronic kidney disease, and 
kidney diseases are the ninth leading cause of death 
in the United States. 
(2) Each day in the United States, on average, 
340 people begin dialysis and 13 people die waiting 
for a kidney transplant. 
(3) Rare kidney diseases like focal segmental 
glomerulosclerosis 
and 
immunoglobulin 
A 
nephropathy are particularly difficult to treat, and 
there are no approved treatments for these diseases. 
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(4) In the absence of approved treatment op-
tions, more than 100,000 people live with rare glo-
merular kidney disease and face dialysis, transplant, 
or death. 
(5) Focal segmental glomerulosclerosis is asso-
ciated with a 50 percent risk of end-stage kidney 
disease within 5 years of diagnosis if partial or com-
plete remission is not achieved. 
(6) Between 20 and 40 percent of individuals 
with immunoglobulin A nephropathy are expected to 
develop end-stage kidney disease within 20 years. 
(7) Rare kidney diseases disproportionately af-
fect Black Americans, who are 3.5 times more likely 
to develop end-stage kidney disease, and 5 times 
more likely than the general population to have focal 
segmental glomerulosclerosis. 
(8) Because approximately one-third of Black 
Americans with focal segmental glomerulosclerosis 
cases are associated with a particular gene, commu-
nities of color would benefit from additional re-
sources to support earlier detection, including ge-
netic and genomic testing and referrals to high-qual-
ity providers. 
(9) The prevalence of end-stage kidney disease 
is exacerbated by diagnostic challenges, barriers to 
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high-quality care, and lack of awareness of disease 
risks. 
(10) Federal spending on end-stage kidney dis-
ease currently accounts for approximately 7 percent 
of Federal Medicare spending. 
(11) The total Medicare spending on both 
chronic kidney disease and end-stage kidney disease 
patients exceeded $120,000,000,000 per year in re-
cent years. 
(12) A focus on renal health and the prevention 
of end-stage kidney disease would improve patient 
outcomes, extend lives, mitigate racial health care 
disparities, and reduce government spending. 
(13) Due in large part to the 21st Century 
Cures Act, new regulatory paradigms have unleashed 
a wave of clinical innovation in the rare kidney dis-
ease space. 
(14) In 2020, the first-ever Rare Kidney Dis-
ease Roundtable outlined urgent needs in the areas 
of diagnosis, education, communities of color, and 
patient support for rare kidney disease patients and 
their families in the United States. 
(15) In 2021, there are over 30 ongoing clinical 
trials underway for treatments for a range of rare 
kidney diseases, offering the first hope for novel 
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therapies for patients living with rare kidney dis-
eases, a new era of preventing end-stage kidney dis-
ease and related Federal costs, and the possibility of 
improving chronic kidney care writ large. 
SEC. 4. DEFINITIONS. 
In this Act: 
(1) DIRECTOR OF NIH.—The term ‘‘Director of 
NIH’’ means the Director of the National Institutes 
of Health. 
(2) NIH.—The term ‘‘NIH’’ means the Na-
tional Institutes of Health. 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
TITLE I—CENTERS OF EXCEL-
LENCE 
AND 
RARE 
KIDNEY 
DISEASE RESEARCH 
SEC. 101. NIDDK CENTERS ON RARE KIDNEY DISEASE RE-
SEARCH. 
Subpart 3 of part C of title IV of the Public Health 
Service Act (42 U.S.C. 281 et seq.) is amended by insert-
ing after section 426 (42 U.S.C. 285c) the following new 
section: 
‘‘SEC. 426A. NIDDK CENTERS ON RARE KIDNEY DISEASE RE-
SEARCH. 
‘‘(a) COOPERATIVE AGREEMENTS AND GRANTS.— 
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‘‘(1) IN GENERAL.—The Director of the Insti-
tute may enter into cooperative agreements with, 
and make grants to, public and private nonprofit en-
tities to pay all or part of the cost of planning, es-
tablishing, or strengthening, and providing basic op-
erating support for, regional centers of excellence for 
rare kidney diseases, including primary glomerular 
disease. Such centers of excellence shall be known as 
NIDDK Centers on Rare Kidney Disease Research. 
‘‘(2) PURPOSES OF CENTERS.—The purposes of 
the centers of excellence funded pursuant to para-
graph (1) shall be— 
‘‘(A) to increase public awareness of rare 
kidney diseases, particularly in communities of 
color; and 
‘‘(B) to develop resources for clinical re-
search into, training in, and demonstration of 
diagnostic, prevention, control, and treatment 
methods for, rare kidney diseases. 
‘‘(3) POLICIES.—A cooperative agreement or 
grant under paragraph (1) shall be entered into in 
accordance with policies established by the Director 
of the National Institutes of Health. 
‘‘(b) COORDINATION WITH OTHER INSTITUTES.— 
The Director of the Institute shall coordinate the activities 
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under this section with similar activities that are related 
to rare kidney disease and conducted by other national 
research institutes, centers, and agencies of the National 
Institutes of Health and by the Food and Drug Adminis-
tration. 
‘‘(c) USES FOR FEDERAL PAYMENTS UNDER COOP-
ERATIVE AGREEMENTS OR GRANTS.—Federal payments 
made under a cooperative agreement or grant under sub-
section (a) may be used for— 
‘‘(1) basic operating costs, including such pa-
tient care costs as are required for research; 
‘‘(2) clinical training, including training for al-
lied health professionals, continuing education for 
health professionals and allied health professions 
personnel, and information programs for the public 
with respect to rare kidney diseases; 
‘‘(3) clinical research and demonstration pro-
grams; 
‘‘(4) education of members of the public, par-
ticularly through outreach to communities of color, 
on the diagnosis (including through routine urinal-
ysis and through genetic testing), prevention, con-
trol, and treatment of rare kidney diseases; and 
‘‘(5) education of individuals diagnosed with 
rare kidney diseases on renal diet and lifestyle, ge-
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netic testing, and programs to promote urinalysis, 
and on mental and emotional health resources for 
families of rare kidney disease patients. 
‘‘(d) PERIOD OF SUPPORT; ADDITIONAL PERIODS.— 
The period of support for a center of excellence under sub-
section (a) may not exceed 5 years, except that such period 
may be extended by the Director of the Institute for addi-
tional periods of not more than 5 years for each center 
if— 
‘‘(1) the operations of such center have been re-
viewed by an appropriate technical and scientific 
peer review group established by the Director of the 
Institute; and 
‘‘(2) such group has recommended to the Direc-
tor of the Institute that such period should be ex-
tended. 
‘‘(e) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $4,000,000 for each of fiscal years 2023 through 
2027.’’. 
SEC. 102. RARE KIDNEY DISEASE PROGRESSION RE-
SEARCH. 
(a) NIH RESEARCH ON RARE KIDNEY DISEASES.— 
The Director of NIH may award grants or contracts to 
public and nonprofit private entities to conduct research 
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on the causes, etiology, symptoms, diagnosis, progression, 
and treatment of rare kidney diseases, including glomer-
ular diseases. 
(b) APPLICATION.—To seek a grant under this sec-
tion, an eligible entity shall submit an application in such 
form, in such manner, and containing such agreements, 
assurances, and information as the Director of NIH deter-
mines to be necessary. 
(c) RESEARCH FUNDED.—Research funded through 
a grant under this section— 
(1) may not include any consideration of qual-
ity-adjusted life years or disability-adjusted life 
years, or other similar mechanisms that discriminate 
against people with disabilities in value and cost-ef-
fectiveness assessments; 
(2) shall include persons of color in populations 
studied in the research; and 
(3) shall include study of genotype-phenotype 
relation to disease progression. 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$1,000,000 for each of fiscal years 2023 through 2027. 
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TITLE II—DIAGNOSTICS 
SEC. 201. DIAGNOSTIC ISSUES RELATING TO RARE KIDNEY 
DISEASE. 
(a) CONFERENCE.— 
(1) IN
GENERAL.—The Secretary shall, not 
later than 12 months after the date of the enact-
ment of this Act, convene a conference to— 
(A) analyze the impact of the decline of 
routine urinalysis on the timely diagnosis of 
rare kidney disease and on the quality of pa-
tient care following a diagnosis of such disease; 
(B) analyze the quality and reliability of 
kidney biopsy in the diagnosis of rare kidney 
disease; 
(C) analyze the impact of genetic and 
genomic testing on preventative care and preci-
sion medicine with respect to rare kidney dis-
ease; 
(D) recommend strategies to reduce dis-
parities in the occurrence and treatment of rare 
kidney disease among different groups, includ-
ing communities of color; and 
(E) recommend strategies to increase rou-
tine urinalysis and to improve technologies to 
diagnose such disease, including genetic testing. 
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(2) CONSULTATION.—In carrying out para-
graph (1), the Secretary shall consult with relevant 
stakeholders, including health care providers, med-
ical professional societies, State-based societies, pub-
lic health experts, State and local public health de-
partments, State medical boards, patient groups, 
drug manufacturers, pharmacists, insurers, and 
other entities with experience in health care, public 
health, and rare disease, as appropriate. 
(b) EARLY INTERVENTION ON GENETIC SCREEN-
ING.— 
(1) STUDY.—The Secretary shall conduct a 
study on— 
(A) whether genetic and genomic testing 
may improve preventative care and precision 
medicine with respect to rare kidney disease; 
(B) whether genetic and genomic testing, 
and in particular testing of the APOL1 gene, 
may reduce disparities in the occurrence and 
treatment of rare kidney disease among dif-
ferent groups, including communities of color; 
(C) whether the Federal Government may 
help to reduce barriers to genetic and genomic 
testing for rare kidney disease, including by— 
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(i) encouraging the expansion of 
health insurance coverage of genetic and 
genomic testing, including diagnostic, pre-
dictive, and presymptomatic testing, and 
DNA sequencing clinical services; 
(ii) supporting the collection of evi-
dence for the clinical utility and appro-
priate use of genetic and genomic tests; 
and 
(iii) improving access to genetic coun-
selors, pathologists, and other relevant pro-
fessions, including strengthening related 
workforce education and training efforts; 
(D) the extent to which coverage provisions 
in the Medicare and Medicaid programs under 
titles XVIII and XIX of the Social Security Act 
(42 U.S.C. 1395 et seq., 1396 et seq.) may re-
strain the use of genetic and genomic testing 
for rare kidney disease that may improve clin-
ical outcomes for beneficiaries; 
(E) whether the Centers for Medicare & 
Medicaid Services may make coverage deter-
minations that better suit a precision medicine 
approach to treatment; and 
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(F) whether genetic and genomic testing 
may improve health outcomes for individuals 
with rare kidney disease. 
(2) REPORT.— 
(A) IN
GENERAL.—Not later than 18 
months after the date of the enactment of this 
Act, the Secretary shall submit a report to the 
Congress on the proceedings of the conference 
under subsection (a) and the results of the 
study under paragraph (1). 
(B) CONSULTATION.—In conducting the 
study under paragraph (1) and developing the 
report required by subparagraph (A), the Sec-
retary shall consult with physicians, other 
health professionals, health educators, health 
professional organizations, relevant companies, 
patients, patient organizations, the Health Re-
sources and Services Administration, the Direc-
tor of NIH, the National Institute of Diabetes 
and Digestive and Kidney Diseases, and the 
Centers for Medicare & Medicaid Services. Such 
consultation shall include consultation activities 
conducted as part of the conference under sub-
section (a). 
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(3) DEFINITION.—In this subsection, the term 
‘‘DNA sequencing clinical services’’, with respect to 
an individual— 
(A) means a determination of an exact se-
quence of deoxyribonucleic acid bases in the ge-
nome of such individual, and, if for the sole 
benefit of the individual, a biological parent of 
such individual for the purpose of determining 
whether one or more potentially disease-causing 
genetic variants are present in the genome of 
such individual or such biological parent; and 
(B) includes— 
(i) sequencing of the entire genome, of 
the exome, of a panel of genes, or other re-
gions of the genome; and 
(ii) any analysis, interpretation, and 
data report derived from such sequencing. 
(c) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$5,000,000 for the period of fiscal years 2023 through 
2027. 
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TITLE III—COMMUNITIES OF 
COLOR 
SEC. 301. UNDERSTANDING AND SLOWING THE PROGRES-
SION OF RARE KIDNEY DISEASE AND TREAT-
MENT IN CERTAIN POPULATIONS. 
(a) STUDY.—The Secretary shall conduct a study 
on— 
(1) the social, behavioral, and biological factors 
leading to rare kidney disease; 
(2) treatment patterns associated with pro-
viding care, under the Medicare program under title 
XVIII of the Social Security Act (42 U.S.C. 1395 et 
seq.), the Medicaid program under title XIX of such 
Act (42 U.S.C. 1396 et seq.), and through private 
health insurance, to populations that are dispropor-
tionately affected by such disease; 
(3) access to nephrologists among populations 
that are disproportionately affected by such disease; 
(4) ongoing efforts and recommendations to 
slow the progression of end-stage kidney disease in 
populations that are disproportionately affected by 
rare kidney disease; and 
(5) patient trust of treating providers among 
populations that are disproportionately affected by 
such disease. 
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(b) REPORT.—Not later than 1 year after the date 
of the enactment of this Act, the Secretary shall submit 
to the Congress a report on the study conducted under 
subsection (a), together with such recommendations as the 
Secretary determines to be appropriate. 
(c) COORDINATION.—In carrying out the activities 
under subsections (a) and (b), the Secretary shall coordi-
nate with the Director of NIH, the Administrator of the 
Center for Medicare & Medicaid Services, the Adminis-
trator of the Health Resources and Services Administra-
tion, and the Director of the Center for Medicare and 
Medicaid Innovation. 
(d) CONSULTATION.—In carrying out the activities 
under subsections (a) and (b), the Secretary shall consult 
with relevant stakeholders, including health care pro-
viders, medical professional societies, State-based soci-
eties, public health experts, State and local public health 
departments, State medical boards, patient groups, drug 
manufacturers, pharmacists, insurers, and other entities 
with experience in health care, public health, health equity, 
and rare disease, as appropriate. 
SEC. 302. COMMUNITIES OF COLOR SERVICE PROGRAM. 
Section 736(b) of the Public Health Service Act (42 
U.S.C. 293) is amended— 
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(1) by redesignating paragraph (7) as para-
graph (8); 
(2) in paragraph (6)(B), by striking ‘‘; and’’ 
and inserting a semicolon; and 
(3) by inserting after paragraph (6) the fol-
lowing: 
‘‘(7) to award fellowships, which may include 
stipends, for postgraduate training in the field of ne-
phrology, for the purposes of— 
‘‘(A) increasing providers’ knowledge of 
issues related to prevention, diagnosis, and 
treatment of rare kidney disease among racial 
and ethnic minority populations, especially the 
prevalence of the gene APOL1; 
‘‘(B) improving the quality of rare kidney 
disease prevention, diagnosis, and treatment de-
livered to racial and ethnic minorities; and 
‘‘(C) increasing the number of culturally 
competent nephrologists; and’’. 
SEC. 303. NIH REPORT ON NIH RESEARCH PROGRAMS. 
The Director of NIH shall prepare and publish on 
the public website of the agency a report on diversity with-
in the programs of the NIH to research kidney disease, 
including— 
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(1) the diversity of recipients of research 
grants; and 
(2) the extent to which grants are awarded to 
research kidney disease among communities of color, 
including disparities in the prevention, diagnosis, 
and treatment of kidney disease among racial and 
ethnic minority populations. 
SEC. 304. PARTNERSHIPS WITH ORGANIZATIONS AND 
AGENCIES. 
(a) HHS PROGRAM.—Under this section or other ap-
plicable provisions of law, the Secretary shall establish a 
program to provide grants to eligible entities to provide 
education and appropriate medical and other referrals for 
patients in communities of color regarding kidney disease, 
including rare kidney disease. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section, an entity shall— 
(1) be— 
(A) a nonprofit or community-based orga-
nization, including any community health cen-
ter; or 
(B) a State or local governmental agency; 
and 
(2) submit to the Secretary an application— 
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(A) at such time and in such manner as 
the Secretary may require; and 
(B) containing— 
(i) a description of how the applicant 
proposes to use the grant funds; and 
(ii) such other information as the Sec-
retary may require. 
(c) REPORTING.— 
(1) BY GRANTEE.—A recipient of a grant under 
this section shall submit annually to the Secretary, 
and make publicly available, a report on the activi-
ties conducted using funds received through the 
grant. 
(2) BY SECRETARY.—Not later than the end of 
fiscal year 2026, the Secretary shall submit to the 
Congress a report that includes— 
(A) a summary of the reports received 
under paragraph (1); 
(B) an evaluation of the effectiveness of 
grants awarded under this section; and 
(C) any recommendations the Secretary 
may have. 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$2,000,000 for each of fiscal years 2023 through 2027. 
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TITLE IV—PROVIDER 
EDUCATION 
SEC. 401. PRIMARY CARE PROVIDER TRAINING GRANT PRO-
GRAM. 
Subpart I of part C of title VII of the Public Health 
Service Act (42 U.S.C. 293k et seq.) is amended by insert-
ing after section 747A (42 U.S.C. 293k–1) the following: 
‘‘SEC. 747B. RARE KIDNEY DISEASE TRAINING FOR PRI-
MARY CARE PROVIDERS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to an accredited public or nonprofit private hospital, 
school of medicine, or academically affiliated physician as-
sistant training program, to a public or private nonprofit 
entity that the Secretary has determined is capable of car-
rying out such grant, or to any consortium of such hos-
pitals, schools, programs, or entities, to plan, develop, and 
operate a professional training program in the field of ne-
phrology for primary care residents, physicians, physician 
assistants, or nurse practitioners, on— 
‘‘(1) methods to detect and diagnose rare kid-
ney disease, including urinalysis and genetic testing; 
‘‘(2) implementing such diagnostic methods in 
their practices; 
‘‘(3) establishing treatment protocols for indi-
viduals diagnosed with rare kidney disease; and 
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‘‘(4) implementing a collaborative care model to 
coordinate care of patients diagnosed with rare kid-
ney disease among health care providers. 
‘‘(b) PRIORITIES IN MAKING AWARDS.—In awarding 
grants under this section, the Secretary may give priority 
to qualified applicants that— 
‘‘(1) have a record of training primary care pro-
viders; 
‘‘(2) establish formal relationships and submit 
joint applications with Federally qualified health 
centers, rural health clinics, or clinics located in un-
derserved areas or that serve underserved popu-
lations; or 
‘‘(3) teach trainees the skills to provide inter-
professional, integrated care through collaboration 
among health professionals, including specialists. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$800,000 for each of fiscal years 2023 through 2027.’’. 
SEC. 402. GRANT PROGRAM FOR DEVELOPMENT AND IM-
PLEMENTATION OF CURRICULA FOR CON-
TINUING EDUCATION ON KIDNEY DISEASE. 
Part C of title VII of the Public Health Service Act 
(42 U.S.C. 293k et seq.) is amended— 
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(1) in the part heading, by striking ‘‘AND PE-
DIATRIC DENTISTRY’’ and inserting ‘‘PEDIATRIC 
DENTISTRY, AND KIDNEY DISEASE’’; and 
(2) by inserting after subpart II (42 U.S.C. 
293m) the following: 
‘‘Subpart III—Continuing Education in Kidney 
Disease 
‘‘SEC. 749C. CURRICULA FOR CONTINUING EDUCATION ON 
KIDNEY DISEASE. 
‘‘(a) GRANTS.—The Secretary may award grants to 
eligible entities for the development and implementation 
of curricula for providing continuing education and train-
ing to health care professionals on identifying, referring, 
and treating individuals with kidney disease. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to seek a 
grant under this section, an entity shall be a public or 
nonprofit entity that— 
‘‘(1) provides continuing education or training 
to health care professionals; or 
‘‘(2) applies for the grant in partnership with 
another entity that provides such education and 
training. 
‘‘(c) PREFERENCE.—In awarding grants under this 
section, the Secretary shall give preference to eligible enti-
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ties proposing to develop and implement curricula for pro-
viding continuing education and training to— 
‘‘(1) primary care providers; or 
‘‘(2) health care professionals who are required, 
as a condition of State licensure, to participate in 
continuing education or training. 
‘‘(d) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $1,600,000 for each of fiscal years 2023 through 
2027.’’. 
TITLE V—COVERAGE AND EX-
PERIMENTS TO REDUCE DI-
ALYSIS 
AND 
TRANSPLANT 
COSTS 
SEC. 501. MEDICAL EXPERTISE IN PHARMACY AND THERA-
PEUTIC COMMITTEES. 
Section 1860D–4(b)(3)(A) of the Social Security Act 
(42 U.S.C. 1395w–104(b)(3)(A)) is amended by striking 
clause (ii) and inserting the following: 
‘‘(ii) INCLUSION
OF
INDEPENDENT 
EXPERTS.—Such 
committee 
shall 
in-
clude— 
‘‘(I) at least one practicing physi-
cian and at least one practicing phar-
macist, each of whom— 
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‘‘(aa) is independent and 
free of conflict with respect to 
the sponsor and plan; and 
‘‘(bb) has expertise in the 
care of elderly or disabled per-
sons; and 
‘‘(II) in the case of a drug ap-
proved to treat a rare disease or con-
dition as defined in section 526 of the 
Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 360bb), at least two 
members that meet the requirements 
described in items (aa) and (bb) of 
subclause (I) and have expertise in 
the field of medicine related to that 
drug.’’. 
SEC. 502. REDUCING DIALYSIS AND TRANSPLANT COSTS 
RELATED TO RARE KIDNEY DISEASE. 
Section 1881(f) of the Social Security Act (42 U.S.C. 
1395rr(f)) is amended by adding at the end the following 
new paragraph: 
‘‘(9)(A) The Secretary shall conduct experiments to 
evaluate methods for treating rare kidney disease, giving 
particular attention to treatments that would delay or 
eliminate the need for dialysis and transplant. 
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