(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to group health plans and quali-
fied health plans as of January 1, 2014. 
TITLE 
II—SUPPORTING 
RE-
SEARCH TO IMPROVE ACCESS 
TO 
HIGH-QUALITY 
KIDNEY 
CARE 
SEC. 201. UNDERSTANDING THE PROGRESSION OF KIDNEY 
DISEASE IN MINORITY POPULATIONS. 
Not later than one year after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services shall complete a study (and submit a report to 
Congress) on— 
(1) the social, behavioral, and biological factors 
leading to kidney disease; and 
(2) efforts to slow the progression of kidney dis-
ease in minority populations that are disproportion-
ately affected by such disease. 
SEC. 202. RECOMMENDATIONS ON DIALYSIS QUALITY AND 
CARE MANAGEMENT RESEARCH GAPS. 
Not later than 2 years after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services shall submit to Congress a report regarding the 
research gaps with respect to the development of quality 
metrics and care management metrics for patients with 
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end-stage renal disease, including pediatric and home di-
alysis patients. Such report shall include recommendations 
about undertaking research to fill such gaps and 
prioritizing such research. 
SEC. 203. GAO STUDY ON TRANSPORTATION BARRIERS TO 
ACCESS KIDNEY CARE. 
(a) IN GENERAL.—The Comptroller General of the 
United States shall conduct an evaluation of the transpor-
tation barriers facing dialysis patients that result in less 
than 100 percent compliance with their plan of care under 
the Medicare program. 
(b) SPECIFIC MATTERS EVALUATED.—In conducting 
the evaluation under subsection (a), the Comptroller Gen-
eral shall examine— 
(1) the costs associated with providing dialysis 
services; 
(2) the number and characteristics of patients 
who miss at least 2 dialysis treatments during a 
month or have shortened treatments because of bar-
riers to transportation; and 
(3) the potential sources of providing dialysis 
patients with such transportation services. 
(c) REPORT.—Not later than the date that is 6 
months after the date of the enactment of this Act, the 
Comptroller General shall submit to Congress a report on 
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the study conducted under subsection (a) together with 
recommendations for such legislation and administrative 
action as the Comptroller General determines appropriate. 
TITLE III—IMPROVING ACCESS 
TO PREVENTIVE CARE FOR 
INDIVIDUALS WITH KIDNEY 
DISEASE 
SEC. 301. IMPROVING ACCESS TO MEDICARE KIDNEY DIS-
EASE EDUCATION. 
(a) IN GENERAL.—Section 1861(ggg)(2) of the So-
cial Security Act (42 U.S.C. 1395x(ggg)(2)) is amended— 
(1) by striking subparagraph (B); and 
(2) in subparagraph (A)— 
(A) by striking ‘‘(A)’’ after ‘‘(2)’’; 
(B) by striking ‘‘and’’ at the end of clause 
(i); 
(C) by striking the period at the end of 
clause (ii) and inserting ‘‘; and’’; 
(D) by redesignating clauses (i) and (ii) as 
subparagraphs (A) and (B), respectively; and 
(E) by adding at the end the following: 
‘‘(C) a renal dialysis facility subject to the 
requirements of section 1881(b)(1) with per-
sonnel who— 
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‘‘(i) provide the services described in 
paragraph (1); and 
‘‘(ii) is a physician (as defined in sub-
section (r)(1)) or a physician assistant, 
nurse practitioner, or clinical nurse spe-
cialist (as defined in subsection (aa)(5)).’’. 
(b) PAYMENT TO RENAL DIALYSIS FACILITIES.— 
Section 1881(b) of such Act (42 U.S.C. 1395rr(b)) is 
amended by adding at the end the following new para-
graph: 
‘‘(15) For purposes of paragraph (14), the single pay-
ment for renal dialysis services under such paragraph shall 
not take into account the amount of payment for kidney 
disease education services (as defined in section 
1861(ggg)). Instead, payment for such services shall be 
made to the renal dialysis facility on an assignment-re-
lated basis under section 1848.’’. 
(c) PROVIDING EDUCATION SERVICES TO INDIVID-
UALS WITH KIDNEY FAILURE.—Section 1861(ggg)(1)(A) 
of the Social Security Act (42 U.S.C. 1395x(ggg)(1)(A)) 
is amended— 
(1) by inserting ‘‘or stage V’’ after ‘‘stage IV’’; 
and 
(2) by inserting ‘‘and who is not receiving dialy-
sis services’’ after ‘‘chronic kidney disease’’. 
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(d) EFFECTIVE DATE.—The amendments made by 
this section apply to kidney disease education services fur-
nished on or after January 1, 2013. 
Æ 
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