To amend title XVIII of the Social Security Act to expand access to home dialysis therapy.

SECTION 1. EXPANDING ACCESS TO HOME DIALYSIS THERAPY.

    (a) Allowing Use of Telehealth for Monthly End Stage Renal Disease-
Related Visits.--
            (1) In general.--Paragraph (3) of section 1881(b) of the 
        Social Security Act (42 U.S.C. 1395rr(b)) is amended--
                    (A) by redesignating subparagraphs (A) and (B) as 
                clauses (i) and (ii), respectively;
                    (B) in clause (ii), as redesignated by subparagraph 
                (A)--
                            (i) by inserting ``subject to subparagraph 
                        (B),'' before ``on a comprehensive''; and
                            (ii) by striking ``under this 
                        subparagraph'' and inserting ``under this 
                        clause'';
                    (C) by striking ``With respect to'' and inserting 
                ``(A) With respect to''; and
                    (D) by adding at the end the following new 
                subparagraph:
    ``(B)(i) Subject to clause (ii), an individual who is determined to 
have end stage renal disease and who is receiving home dialysis may 
choose to receive monthly end stage renal disease-related visits, 
furnished on or after January 1, 2019, via telehealth.
    ``(ii) Clause (i) shall apply to an individual only if the 
individual receives a face-to-face visit, without the use of 
telehealth--
            ``(I) in the case of the initial three months of home 
        dialysis of such individual, at least monthly; and
            ``(II) after such initial three months, at least once every 
        three consecutive months.''.
            (2) Conforming amendment.--Paragraph (1) of such section is 
        amended by striking ``paragraph (3)(A)'' and inserting 
        ``paragraph (3)(A)(i)''.
    (b) Expanding Originating Sites for Telehealth To Include Renal 
Dialysis Facilities and the Home for Purposes of Monthly End Stage 
Renal Disease-Related Visits.--
            (1) In general.--Section 1834(m) of the Social Security Act 
        (42 U.S.C. 1395m(m)) is amended--
                    (A) in paragraph (4)(C)(ii), by adding at the end 
                the following new subclauses:
                                    ``(IX) A renal dialysis facility, 
                                but only for purposes of section 
                                1881(b)(3)(B).
                                    ``(X) The home of an individual, 
                                but only for purposes of section 
                                1881(b)(3)(B).''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(5) Treatment of home dialysis monthly esrd-related 
        visit.--The geographic requirements described in paragraph 
        (4)(C)(i) shall not apply with respect to telehealth services 
        furnished on or after January 1, 2019, for purposes of section 
        1881(b)(3)(B), at an originating site described in subclause 
        (VI), (IX), or (X) of paragraph (4)(C)(ii)).''.
            (2) No facility fee if originating site for home dialysis 
        therapy is the home.--Section 1834(m)(2)(B) of the Social 
        Security (42 U.S.C. 1395m(m)(2)(B)) is amended--
                    (A) by redesignating clauses (i) and (ii) as 
                subclauses (I) and (II), respectively, and by indenting 
                each of such subclauses 2 ems to the right;
                    (B) in subclause (II), as redesignated by 
                subparagraph (A), by striking ``clause (i) or this 
                clause'' and inserting ``subclause (I) or this 
                subclause'';
                    (C) by striking ``site.--With respect to'' and 
                inserting ``site.--
                            ``(i) In general.--Subject to clause (ii), 
                        with respect to''; and
                    (D) by adding at the end the following new clause:
                            ``(ii) No facility fee if originating site 
                        for home dialysis therapy is the home.--No 
                        facility fee shall be paid under this 
                        subparagraph to an originating site described 
                        in subclause (X) of paragraph (4)(C)(ii).''.
    (c) Clarification Regarding Telehealth Provided to Beneficiaries.--
Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended--
            (1) in subparagraph (H), by striking ``; or'' and inserting 
        a semicolon;
            (2) in subparagraph (I), by striking the period at the end 
        and inserting ``; or''; and
            (3) by adding at the end the following new subparagraph:
                    ``(J) the provision of telehealth on or after 
                January 1, 2019, to individuals with end stage renal 
                disease under title XVIII by a health care provider for 
                the purpose of furnishing of telehealth.''.
    (d) Study and Report on Further Expansion.--
            (1) Study.--The Comptroller General of the United States 
        shall conduct a study to examine the benefits and drawbacks of 
        expanding the coverage under the Medicare program under title 
        XVIII of the Social Security Act of renal dialysis services as 
        telehealth services, pursuant to the amendments made by this 
        section, to include coverage of renal dialysis services 
        furnished via telehealth and other store-and-forward 
        technologies.
            (2) Report.--Not later than two years after the date of the 
        enactment of this Act, the Comptroller General shall submit to 
        Congress a report on the results of the study conducted under 
        paragraph (1).

Summary: This bill amends title XVIII (Medicare) of the Social Security Act to allow a&nbsp;Medicare beneficiary who has end-stage renal disease (ESRD) and is receiving home dialysis to receive monthly ESRD-related visits via telehealth, provided that the beneficiary also receives face-to-face visits periodically. Specified facility fees and&nbsp;geographic requirements shall not apply with respect to the provision of such services via telehealth. The Government Accountability Office must study and report to Congress on the further expansion of Medicare coverage of renal dialysis services furnished via telehealth.