In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Q: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Fairness for Homeowners Act of 
2007''.

SEC. 2. ORIGINATIONS OF CONSUMER CREDIT TRANSACTIONS SECURED BY THE 
              CONSUMER'S PRINCIPAL DWELLING.

    (a) In General.--The Truth in Lending Act (15 U.S.C. 1601 et seq.) 
is amended by inserting after section 129 the following new section:
``Sec. 129A. Originations of consumer credit transactions secured by 
              the consumer's principal dwelling
    ``(a) Definitions.--For purposes of this section, the following 
definitions shall apply:
            ``(1) Fully indexed rate.--The term `fully indexed rate' 
        equals the index rate prevailing at the time a consumer credit 
        transaction secured by a consumer's principal dwelling is 
        originated, plus the margin that will apply after the 
        expiration of an introductory interest rate.
            ``(2) Mortgage broker.--The term `mortgage broker' means 
        any person who is defined as a mortgage broker under applicable 
        State law.
    ``(b) Requirements for Originators.--
            ``(1) Ability to pay.--
                    ``(A) In general.--No creditor or mortgage broker 
                may make, provide, or arrange for any consumer credit 
                transaction secured by a consumer's principal dwelling 
                without verifying the consumer's reasonable ability to 
                pay the scheduled payments of the following, as 
                applicable: principal; interest; real estate taxes; 
                homeowner's insurance, assessments, and mortgage 
                insurance premiums.
                    ``(B) Variable interest rate.--In the case of any 
                consumer credit transaction secured by a consumer's 
                principal dwelling for which the applicable annual 
                percentage rate may vary over the life of the credit, 
                the reasonable ability to pay shall be determined, for 
                purposes of this paragraph, on the basis of a fully 
                indexed rate plus 200 basis points and a repayment 
                schedule which achieves full amortization over the life 
                of the extension of credit.
                    ``(C) Verification of consumer income and financial 
                resources.--In the case of any consumer credit 
                transaction secured by a consumer's principal dwelling, 
                the income and financial resources of the consumer 
                shall be verified for purposes of this paragraph by tax 
                returns, payroll receipts, bank records, or other 
                similarly reliable documents.
                    ``(D) Other criteria.--No provision of this 
                paragraph shall be construed as prohibiting reliance on 
                criteria other than a consumer's income and financial 
                resources to establish the reasonable ability of the 
                consumer to repay any consumer credit transaction 
                secured by the consumer's principal dwelling, to the 
                extent such other criteria are also verified through 
                reasonably reliable methods and documentation.
                    ``(E) Consumer statement is insufficient proof.--A 
                statement by a consumer of the consumer's income or 
                financial resources shall not be sufficient to 
                establish the existence of any income or financial 
                resources when verifying the reasonable ability of the 
                consumer to repay any consumer credit transaction 
                secured by the consumer's principal dwelling, for 
                purposes of this paragraph.
            ``(2) Prohibition on steering.--No creditor or mortgage 
        broker may make, provide, or arrange for any consumer credit 
        transaction secured by a consumer's principal dwelling that is 
        of a lower investment grade if--
                    ``(A) the consumer's credit score; or
                    ``(B) comparable underwriting data, in any case in 
                which the creditor or mortgage broker does not utilize 
                credit scoring or a credit score for the consumer is 
                unavailable,
        indicates that the borrower may qualify for a consumer credit 
        transaction, available from or through the creditor or mortgage 
        broker, that is of a higher investment grade.
            ``(3) Prohibition on prepayment penalties for arms.--
                    ``(A) In general.--In the case of any consumer 
                credit transaction secured by a consumer's principal 
                dwelling that provides for variable rates of interest 
                on the credit extended under the transaction, the 
                transaction may not contain terms under which a 
                consumer must pay a prepayment penalty for paying all 
                or part of the principal before the date on which the 
                principal is due.
                    ``(B) Exclusion for jumbo mortgages.--Subparagraph 
                (A) shall not apply to any consumer credit transaction 
                secured by a consumer's principal dwelling the 
                principal amount (as defined in subsection (c)(2)) of 
                which exceeds the maximum dollar amount limitation (for 
                a residence of the applicable size) on the amount of 
                the principal obligation of a mortgage for a 1- to 4-
                family residence that may be purchased by the Federal 
                Home Loan Mortgage Corporation, as then in effect 
                pursuant to section 305(a)(2) of the Federal Home Loan 
                Mortgage Corporation Act.
    ``(c) Limitation on Financed Points, Charges, and Fees.--
            ``(1) In general.--No creditor or mortgage broker may, in 
        connection with any consumer credit transaction secured by the 
        consumer's principal dwelling, include in the principal amount 
        of such transaction any portion of any qualified finance charge 
        in excess of the amount which is equal to 5 percent of the 
        principal amount of the transaction.
            ``(2) Definitions.--For purposes of this subsection, the 
        following definitions shall apply:
                    ``(A) Qualified finance charge.--The term 
                `qualified finance charge' means the sum of--
                            ``(i) the finance charge as determined 
                        under section 106, minus any interest and time 
                        price differential; and
                            ``(ii) all compensation paid to a mortgage 
                        broker from any source in connection with this 
                        transaction.
                    ``(B) Principal amount.--The term `principal 
                amount' means--
                            ``(i) in the case of any consumer credit 
                        transaction under an open end credit plan 
                        secured by the consumer's principal dwelling, 
                        the maximum amount of credit that may be 
                        extended under the terms of such plan as 
                        determined without taking into account any 
                        amount included in determining the finance 
                        charge under section 106; and
                            ``(ii) in the case of any other consumer 
                        credit transaction secured by a consumer's 
                        principal dwelling, the amount financed (as 
                        defined in section 138(a)(2)).
            ``(3) Prohibition on excessive finance charges.--No 
        creditor or mortgage broker may, in connection with any 
        consumer credit transaction secured by the consumer's principal 
        dwelling, impose or receive any amount included in determining 
        the qualified finance charge for such transaction that exceeds 
        the amount which is equal to 5 percent of the principal amount 
        of the transaction.
            ``(4) Exception.--This subsection shall not apply to any 
        consumer credit transaction secured by the consumer's principal 
        dwelling that is ensured or guaranteed by the Secretary of 
        Housing and Urban Development, the Secretary of Veterans 
        Affairs, or the Farmers Home Administration.
    ``(d) Mortgage Broker Duties of Agency.--
            ``(1) In general.--Any mortgage broker acting to obtain or 
        arrange for any consumer credit transaction secured by the 
        consumer's principal dwelling shall be considered to have an 
        agency relationship with the consumer in all cases by operation 
        of law and shall comply with the following duties:
                    ``(A) Mortgage brokers shall act in the consumer's 
                best interest and in the utmost good faith toward each 
                consumer and shall not compromise a consumer's right or 
                interest in favor of another's right or interest, 
                including a right or interest of the mortgage broker.
                    ``(B) A mortgage broker shall not accept, give, or 
                charge any undisclosed compensation or realize any 
                undisclosed remuneration, either through direct or 
                indirect means, that inures to the benefit of the 
                mortgage broker on an expenditure made for the 
                consumer.
                    ``(C) Mortgage brokers shall carry out all lawful 
                instructions given by the consumer.
                    ``(D) Mortgage brokers shall disclose to consumers 
                all material facts of which the mortgage broker has 
                knowledge which might reasonably affect the consumer's 
                rights, interests, or ability to receive the consumer's 
                intended benefit from the consumer credit transaction, 
                but not facts which are reasonably susceptible to the 
                knowledge of the consumer.
                    ``(E) Mortgage brokers shall use reasonable care in 
                performing duties.
                    ``(F) Mortgage brokers shall account to a consumer 
                for all the consumer's money and property received as 
                agent.
            ``(2) Scope.--The duty of agency between mortgage broker 
        and consumer applies when the mortgage broker is acting in the 
        capacity of mortgage broker providing mortgage brokerage 
        services with respect to any consumer credit transaction 
        secured by the consumer's principal dwelling for which the 
        broker is not the creditor.
            ``(3) Rules of construction.--
                    ``(A) Fees for services rendered.--No provision of 
                this subsection shall be construed as prohibiting a 
                mortgage broker from contracting for or collecting a 
                fee for services rendered which had been disclosed to 
                the consumer in advance of the provision of such 
                services.
                    ``(B) Duty of broker.--No provision of this 
                subsection shall be construed as requiring a mortgage 
                broker--
                            ``(i) to obtain or arrange for any consumer 
                        credit transaction secured by the consumer's 
                        principal dwelling on behalf of a consumer that 
                        contains terms or conditions not available to 
                        the mortgage broker in the mortgage broker's 
                        usual course of business; or
                            ``(ii) to obtain or arrange for any 
                        consumer credit transaction secured by the 
                        consumer's principal dwelling from a creditor 
                        with whom the mortgage broker does not have a 
                        business relationship.
    ``(e) Independent Verification of Consumer Counseling Before 
Refinancing Special Mortgages.--
            ``(1) In general.--No creditor or mortgage broker may make, 
        provide, or arrange for any consumer credit transaction secured 
        by the consumer's principal dwelling all or a portion of the 
        proceeds of which are used to fully or partially pay off a 
        special mortgage unless the borrower has obtained a written 
        certification from an authorized independent loan counselor 
        that the borrower has received counseling on the advisability 
        of the transaction.
            ``(2) Definitions.--For purposes of this section, the 
        following definitions shall apply:
                    ``(A) Special mortgage.--The term `special 
                mortgage' means any consumer credit transaction secured 
                by the consumer's principal dwelling that was 
                originated, subsidized, funded, or guaranteed by or 
                through a State, tribal, or local government, or 
                nonprofit organization, that bears 1 or more of the 
                following nonstandard payment terms which substantially 
                benefit the consumer:
                            ``(i) Payments vary with income.
                            ``(ii) Payments of principal or interest 
                        are not required or can be deferred under 
                        specified conditions.
                            ``(iii) Principal or interest is forgivable 
                        under specified conditions.
                            ``(iv) Either no interest or an annual 
                        interest rate of 2 percent or less is charged 
                        in connection with the loan.
                    ``(B) Authorized loan counselor.--The term 
                `authorized independent loan counselor' means any 
                nonprofit, third-party individual or organization 
                providing homebuyer education programs, foreclosure 
                prevention services, mortgage loan counseling, or 
                credit counseling that is certified by the Secretary of 
                Housing and Urban Development, or certified by any 
                State housing agency or nonprofit organization 
                designated by such Secretary, for such purposes.
    ``(f) Minimum Financial Requirements for Mortgage Brokers.--No 
mortgage broker may obtain or arrange for any consumer credit 
transaction secured by the consumer's principal dwelling unless at all 
times the mortgage broker--
            ``(1) maintains a minimum net worth, net of intangibles, of 
        at least $500,000, as determined in accordance with generally 
        accepted accounting principles; or
            ``(2) maintains a surety bond or irrevocable letter of 
        credit in the amount of $50,000.
    ``(g) Enforcement.--For purposes of providing a cause of action for 
any failure by a mortgage broker to comply with any requirement imposed 
under this section, section 130(a) shall be applied with respect to any 
such failure--
            ``(1) by substituting `mortgage broker' for `creditor' each 
        place such term appears in such section; and
            ``(2) by treating all qualified finance charges (as defined 
        in subsection (c)(2)(A)) incurred in the origination of any 
        consumer credit transaction secured by the consumer's principal 
        dwelling as actual damages sustained by the consumer as a 
        result of the failure.
    ``(h) Exclusion of Reverse Mortgages.--This section shall not apply 
with respect to any consumer mortgage transaction that constitutes a 
reverse mortgage.''.
    (b) Technical and Conforming Amendments.--The Truth in Lending Act 
is amended--
            (1) in section 103 (u) (15 U.S.C. 1602(u)), by striking 
        ``and the disclosures required by section 129(a)'' and 
        inserting ``and the provisions of section 129 and 129A''; and
            (2) in section 130 (15 U.S.C. 1640), by inserting ``or 
        129A'' after section 129 each place such term appears.
    (c) Clerical Amendment.--The table of sections for chapter 2 of the 
Truth in Lending Act is amended by inserting after the item relating to 
section 129 the following new item:

``129A. Originations of consumer credit transactions secured by the 
                            consumer's principal dwelling.''.

A: Fairness for Homeowners Act of 2007 - Amends the Truth in Lending Act to prohibit any creditor or mortgage broker from making, providing, or arranging for any consumer credit transaction secured by a consumer's principal dwelling without verifying the consumer's reasonable ability to make the scheduled payments of principal, interest (including variable interest), real estate taxes, homeowner's insurance, assessments, and mortgage insurance premiums.

Prescribes criteria for determining the reasonable ability to make such payments.

Prohibits steering (arranging for a lower investment grade credit transaction if the consumer qualifies for a higher investment grade transaction) and prepayment penalties for adjustable rate mortgages (ARMs) that are not jumbo mortgages.

Limits financed points, finance charges, and fees to 5% of a transaction's principal, unless the transaction is ensured or guaranteed by the Secretary of Housing and Urban Development, the Secretary of Veterans Affairs, or the Farmers Home Administration.

Specifies duties of agency for mortgage brokers acting to obtain or arrange for any consumer credit transaction secured by the consumer's principal dwelling.

Requires creditors and mortgage brokers to obtain independent verification that a borrower seeking to refinance a special mortgage has received counseling on the transaction's advisability. Defines "special mortgage" as one that: (1) was originated, subsidized, funded, or guaranteed by or through a state, tribal, or local government, or nonprofit organization; and (2) bears one or more specified nonstandard payment terms which substantially benefit the consumer.

Prescribes minimum financial requirements for mortgage brokers.

Excludes reverse mortgages from coverage by this Act.
****
Q: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Tuition Assistance for Families 
Act''.

SEC. 2. EXPANSION OF TUITION TAX DEDUCTION.

    (a) In General.--Subparagraphs (A) and (B) of section 222(b)(2) of 
the Internal Revenue Code of 1986 (relating to dollar limitation) are 
amended to read as follows:
                    ``(A) In general.--The applicable dollar limit 
                shall be equal to--
                            ``(i) in the case of a taxpayer whose 
                        adjusted gross income for the taxable year does 
                        not exceed $65,000 ($130,000 in the case of a 
                        joint return), $12,000,
                            ``(ii) with respect to any taxable year 
                        beginning in 2004 or 2005, in the case of a 
                        taxpayer not described in clause (i) whose 
                        adjusted gross income for the taxable year does 
                        not exceed $80,000 ($160,000 in the case of a 
                        joint return), $2,000, and
                            ``(iii) in the case of any other taxpayer, 
                        zero.
                    ``(B) Inflation adjustment.--
                            ``(i) In general.--In the case of any 
                        taxable year beginning after 2003, each dollar 
                        amount referred to in subparagraph (A)(i) shall 
                        be increased by an amount equal to--
                                    ``(I) such dollar amount, 
                                multiplied by
                                    ``(II) the cost-of-living 
                                adjustment determined under section 
                                (1)(f)(3) for the calendar year in 
                                which the taxable year begins, by 
                                substituting `2002' for `1992'.
                            ``(ii) Rounding.--If any amount as adjusted 
                        under clause (i) is not a multiple of $100, 
                        such amount shall be rounded to the next lowest 
                        multiple of $100.''.
    (b) Permanent Deduction.--Section 222 of the Internal Revenue Code 
of 1986 (relating to qualified tuition and related expenses) is amended 
by striking subsection (e).
    (c) Effective Date.--The amendments made by this section shall 
apply to payments made in taxable years beginning after December 31, 
2002.

SEC. 3. EXPANSION OF LIFETIME LEARNING CREDIT.

    (a) In General.--Section 25A(c)(1) of the Internal Revenue Code of 
1986 (relating to per taxpayer credit) is amended--
            (1) by striking ``20 percent'' and inserting ``25 
        percent'', and
            (2) by striking ``$10,000 ($5,000 in the case of taxable 
        years beginning before January 1, 2003)'' and inserting 
        ``$12,000''.
    (b) Inflation Adjustment.--Section 25A(h) of the Internal Revenue 
Code of 1986 (relating to inflation adjustments) is amended by adding 
at the end the following new paragraph:
            ``(3) Dollar limitation on amount of lifetime learning 
        credit.--
                    ``(A) In general.--In the case of any taxable year 
                beginning after 2003, the dollar amount referred to in 
                subsection (c)(1) shall be increased by an amount equal 
                to--
                            ``(i) such dollar amount, multiplied by
                            ``(ii) the cost-of-living adjustment 
                        determined under section (1)(f)(3) for the 
                        calendar year in which the taxable year begins, 
                        by substituting `2002' for `1992'.
                    ``(B) Rounding.--If any amount as adjusted under 
                subparagraph (A) is not a multiple of $100, such amount 
                shall be rounded to the next lowest multiple of 
                $100.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to payments made in taxable years beginning after December 31, 
2002.

SEC. 4. INCREASE IN INCOME LIMITS FOR HOPE AND LIFETIME LEARNING 
              CREDITS.

    (a) In General.--Section 25A(d)(2)(A)(ii) of the Internal Revenue 
Code of 1986 (relating to limitation based on modified adjusted gross 
income) is amended by striking ``$40,000 ($80,000'' and inserting 
``$55,000 ($110,000''.
    (b) Conforming Amendments.--Section 25A(h)(2)(A) of the Internal 
Revenue Code of 1986 is amended--
            (1) by striking ``2001'' in the matter preceding clause (i) 
        and inserting ``2003'',
            (2) by striking ``the $40,000 and $80,000 amounts'' in such 
        matter and inserting ``the $55,000 and $110,000 amounts'', and
            (3) by striking ``2000'' in clause (ii) and inserting 
        ``2002''.
    (c) Effective Date.--The amendments made by this section shall 
apply to payments made in taxable years beginning after December 31, 
2002.

SEC. 5. MAXIMUM PELL GRANT AWARDS.

    The Department of Education Appropriations Act, 2002 (Public Law 
107-116) is amended under the heading ``Student Financial Assistance'' 
by striking ``$4,000'' and inserting ``$4,500''.

SEC. 6. ACADEMIC ACHIEVEMENT SCHOLARSHIPS.

    (a) Scholarships.--The Secretary of Education is authorized to 
award a scholarship for academic year 2003-2004 and succeeding academic 
years to each student in a State who graduated in the top 5 percent of 
such student's graduating class from secondary school in academic year 
2002-2003 or a succeeding academic year to enable such student to pay 
the cost of attendance at an institution of higher education.
    (b) Amount.--Each scholarship awarded under this section shall be 
in the amount of $1,000.
    (c) Use.--Each student awarded a scholarship under this section 
shall use the funds to pay the cost of attendance at an institution of 
higher education.
    (d) Construction of Needs Provision.--
            (1) In general.--Except as provided in paragraph (2), 
        nothing in this section, or any other Act, shall be construed 
        to permit the receipt of a scholarship under this section to be 
        counted for any needs test in connection with the awarding of 
        any grant or the making of any loan under the Higher Education 
        Act of 1965 (20 U.S.C. 1001 et seq.) or any other provision of 
        Federal law relating to educational assistance.
            (2) Exception.--In determining the need of a student for 
        Federal financial assistance, an institution of higher 
        education may take into consideration the amount of scholarship 
        assistance received under this section if the total amount of 
        scholarship assistance received under this section plus the 
        amount of other financial assistance available to a student 
        exceeds the student's cost of attendance at the institution.
    (e) Regulations.--The Secretary of Education shall promulgate 
regulations regarding how scholarships awarded under this section will 
be allocated to both public and private school students.
    (f) Definitions.--In this section:
            (1) Cost of attendance.--The term `cost of attendance' has 
        the meaning given the term in section 472 of the Higher 
        Education Act of 1965 (20 U.S.C. 1087ll).
            (2) Institution of higher education.--The term `institution 
        of higher education' has the meaning given the term in section 
        101 of the Higher Education Act of 1965 (20 U.S.C. 1001).

A: Tuition Assistance for Families Act - Amends the Internal Revenue Code to expand the tax deduction for qualified higher education tuition and related expenses. Sets such deduction at: (1) $12,000 for those with incomes up to $65,000 single or $130,000 joint; and (2) $2,000 for those whose incomes are above that level, but not more than $80,000 single or $160,000 joint. Provides inflation adjustment. Makes such tuition deduction permanent.Increases the amount of the Lifetime Learning tax credit percentage from 20 to 25 percent. Increases the amount of education expenses subject to such credit from $10,000 to $12,000 (thus making the maximum allowable credit $3,000, rather than the current $2,000). Provides inflation adjustment.Raises annual income limits for the Hope and Lifetime Learning tax credits to $55,000 single and $110,000 joint.Amends the Department of Education Appropriations Act, 2002 (Public Law 107-116) to increase the maximum Pell Grant award from $4,000 to $4,500.Establishes an academic achievement scholarship program. Authorizes the Secretary of Education to award a $1,000 college scholarship to each student in a State who graduates in the top five percent of his or her secondary school's graduating class.
****
Q: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Chronic Kidney Disease 
Management Act of 2003''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Clinical research indicates that in 2003, more than 
        300,000 Americans suffer from end-stage renal disease.
            (2) Clinical research also indicates that by 2010, the 
        number of Americans who will suffer from end-stage renal 
        disease is expected to exceed 600,000.
            (3) Clinical research also indicates that adult patients 
        who are diagnosed as having advanced chronic kidney disease 
        have a high likelihood of requiring treatment for end-stage 
        renal disease within 6- to 18-month period after such 
        diagnosis.
            (4) Clinical research also indicates that appropriate 
        medical treatment, and education and counseling services, 
        furnished during the period referred to in paragraph (3) has 
        been found to--
                    (A) decrease significantly both morbidity and 
                mortality rates for such patients when treatment for 
                end-stage renal disease is initiated; and
                    (B) slow down the progression from advanced kidney 
                disease to end-stage renal disease.

SEC. 3. DELAYING ONSET OF AND DECREASING MORBIDITY AND MORTALITY RATES 
              FOR END-STAGE RENAL DISEASE.

    (a) Medicare Coverage of Chronic Kidney Disease Patients.--
            (1) In general.--Section 226A of the Social Security Act 
        (42 U.S.C. 426-1) is amended--
                    (A) by redesignating the last subsection as 
                subsection (e); and
                    (B) by inserting after subsection (c) the following 
                new subsection:
    ``(d)(1)(A) Notwithstanding any provision to the contrary in 
section 226 of title XVIII, every qualified chronic kidney disease 
patient (as defined in paragraph (2)) shall, in accordance with the 
succeeding provisions of this section, be entitled to benefits under 
part A and eligible to enroll under part B of title XVIII, subject to 
the deductible, premium, and coinsurance provisions of that title.
    ``(B) No qualified chronic kidney disease patient may enroll under 
part C of title XVIII.
    ``(2) For purposes of this subsection, the term `qualified chronic 
kidney disease patient' means an individual--
            ``(A) who would otherwise be described in subsection (a) 
        but for paragraph (2) of that subsection;
            ``(B) who has been diagnosed with chronic kidney disease;
            ``(C) with respect to whom, a physician makes a 
        certification that the individual--
                    ``(i) has advanced chronic kidney disease (as 
                defined in paragraph (3)), and, in the case of such an 
                individual who is under 18 years of age, will likely 
                need dialysis treatments or a kidney transplant within 
                the 18-month period beginning on the date of the 
                certification; and
                    ``(ii) may benefit from a program of pre-ESRD 
                services (as defined in section 1861(ww)(1)); and
            ``(D) who does not have health insurance coverage, as 
        certified by the individual, parent, or legal guardian, as the 
        case may be.
    ``(3) For purposes of this subsection, the term `advanced chronic 
kidney disease' means with respect to kidney disease a glomerular 
filtration rate of 30ml/min per 1.73 m2 or less.''.
            (2) Conforming amendment.--Section 1811 of such Act (42 
        U.S.C. 1395c) is amended by inserting before the period the 
        following: ``or who are qualified chronic kidney disease 
        patients (as defined in section 226A(d)(2))''.
            (3) Effective date.--The amendments made by this subsection 
        shall take effect on the date that is 6 months after the date 
        of the enactment of this Act.
    (b) Coverage of Pre-ESRD Services.--
            (1) In general.--Section 1861(s)(2) of the Social Security 
        Act (42 U.S.C. 1395x(s)(2)) is amended--
                    (A) by striking ``and'' at the end of subparagraph 
                (U);
                    (B) by inserting ``and'' at the end of subparagraph 
                (V); and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(W) pre-ESRD services (as defined in subsection (ww)(1)) 
        for an individual who has been diagnosed with chronic kidney 
        disease and, with respect to whom, a physician makes a 
        certification described in section 226A(d)(2)(C);''.
            (2) Services described.--Section 1861 of such Act (42 
        U.S.C. 1395x) is amended by adding at the end the following new 
        subsection:

                          ``Pre-ESRD Services

    ``(ww) The term `pre-ESRD Services' means any or all of the 
following services:
            ``(1) Individual and group nutritional counseling services 
        for the purpose of chronic kidney disease management that are 
        furnished by a registered dietitian or nutrition professional 
        (as defined in subsection (vv)(2)) pursuant to a referral by a 
        physician (as defined in subsection (r)(1)).
            ``(2) Counseling furnished by qualified health care 
        providers that--
                    ``(A) provides comprehensive information regarding 
                the management of comorbidities, and the prevention of 
                uremic complications;
                    ``(B) ensures active participation of the 
                individual in the choice of therapy or therapies; and
                    ``(C) provides comprehensive information regarding 
                modalities of treatment for kidney disease and end-
                stage renal disease, including organ transplantation, 
                hemodialysis, peritoneal dialysis, and home dialysis.
            ``(3) Counseling, items and services, including tissue 
        typing, furnished by qualified health care providers for 
        preparation of possible organ transplantation.
            ``(4) Items and services furnished by qualified health care 
        providers for the preparation of vascular access required for 
        dialysis treatment.
            ``(5) Such other services as the Secretary determines 
        appropriate, in consultation with national organizations 
        representing individuals and entities who furnish pre-ESRD 
        services and patients receiving such services.''.
            (3) Qualification criteria.--The Secretary of Health and 
        Human Services shall establish such criteria as the Secretary 
        determines appropriate for qualifications required for 
        individuals to furnish pre-ESRD services under section 1861(ww) 
        of the Social Security Act, as added by paragraph (2), after 
        consulting with representatives of the following:
                    (A) Physicians, including board certified 
                nephrologists.
                    (B) Certified nephrology nurses.
                    (C) Certified nephrology dietitians.
                    (D) Certified nephrology nutritionists.
                    (E) Certified nephrology social workers.
                    (F) Kidney patient organizations.
                    (G) Health educators.
                    (H) Dialysis facilities.
                    (I) Transplant centers.
                    (J) Network administrative organization designated 
                under section 1881(c) of the Social Security Act (42 
                U.S.C. 1395rr(c)).
                    (K) Such other individuals with appropriate 
                expertise as the Secretary may specify.
    (c) Payment Amount.--
            (1) In general.--Section 1833(a)(1) of the Social Security 
        Act (42 U.S.C. 1395l(a)(1)) is amended--
                    (A) by striking ``and'' before ``(U)''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (V) with respect to pre-ESRD 
                services, the amount paid shall be 80 percent of the 
                amount determined under the fee schedule established 
                under section 1834(e)''.
            (2) Establishment of fee schedule.--Section 1834 of such 
        Act (42 U.S.C. 1395m) is amended by inserting after subsection 
        (d) the following new subsection:
    ``(e) Fee Schedule for Pre-ESRD Services.--
            ``(1) In general.--The Secretary shall establish a fee 
        schedule for payment for pre-ESRD services in accordance with 
        the requirements of this subsection.
            ``(2) Considerations.--In establishing such fee schedule, 
        the Secretary shall--
                    ``(A) establish mechanisms to promote the efficient 
                delivery of care;
                    ``(B) establish definitions for pre-ESRD services 
                which link payments to the type of services provided;
                    ``(C) consider appropriate regional and operational 
                differences; and
                    ``(D) consider adjustments to payment rates to 
                account for inflation and other relevant factors.
            ``(3) Consultation.--In establishing the fee schedule for 
        pre-ESRD services under this subsection, the Secretary shall 
        consult with various national organizations representing 
        individuals and entities who furnish pre-ESRD services and 
        patients receiving such services.
            ``(4) Coding system.--The Secretary may require the claim 
        for any services for which the amount of payment is determined 
        under this subsection to include a code (or codes) under a 
        uniform coding system specified by the Secretary that 
        identifies the services furnished.''.
            (3) Permitting dialysis facilities to bill for pre-esrd 
        services furnished in the facility.--Section 1881(b) is amended 
        by adding at the end the following new paragraph:
    ``(12) A renal dialysis facility may provide for the furnishing of 
some or all pre-ESRD services (as defined in section 1861(ww)(2). The 
facility may submit to the Secretary a claim for payment for such 
services furnished in the facility, and the Secretary shall not require 
the facility, or the employee of the facility who is qualified to 
furnish such services, to apply for a separate provider number for 
purposes of payment under this title.''.
    (d) Annual Reports to Congress.--
            (1) In general.--Not later than 18 months after the date of 
        the enactment of this Act, and annually thereafter, the 
        Secretary of Health and Human Services shall submit to Congress 
        reports on the matters described in paragraph (2) with respect 
        to pre-ESRD services (described in section 1861(ww) of the 
        Social Security Act) furnished during the preceding year.
            (2) Matters described.--Reports under paragraph (1) shall 
        include--
                    (A) an assessment of the number of medicare 
                beneficiaries who are entitled to pre-ESRD services;
                    (B) an assessment of the number of medicare 
                beneficiaries who are furnished such services under the 
                medicare program;
                    (C) an analysis of the patient outcomes and costs 
                of furnishing care to the medicare beneficiaries who 
                are furnished such pre-ESRD services as compared to 
                such outcomes and costs with respect to other 
                beneficiaries for the same health conditions;
                    (D) an evaluation of patient satisfaction; and
                    (E) such recommendations for legislative and 
                administrative action as the Secretary determines 
                appropriate.

SEC. 4. DEMONSTRATION PROJECT FOR HOME DIALYSIS PEER EDUCATION.

    (a) Establishment.--Subject to the succeeding provisions of this 
section, the Secretary shall establish demonstration projects to 
evaluate methods through which peer education may--
            (1) slow down or prevent the progress of kidney disease to 
        end-stage renal disease in medicare beneficiaries;
            (2) improve the management of co-morbid conditions 
        associated with kidney disease;
            (3) improve choice in selection of renal replacement 
        therapies (including home dialysis); and
            (4) improve other outcomes (such as employment).
    (b) Conduct Through Kidney Patient Organizations.--The Secretary 
shall carry out the demonstration projects in collaboration with kidney 
patient organizations with demonstrated expertise in kidney patient 
peer education programs.
    (c) Payment.--Payment under the demonstration project shall be made 
by the Secretary in such amounts and using such methodology as the 
Secretary determines to be appropriate.
    (d) Voluntary Participation.--Participation of medicare 
beneficiaries in the demonstration projects shall be voluntary.
    (e) Demonstration Projects Sites.--Not later than 1 years after the 
date of the enactment of this Act, the Secretary shall conduct no fewer 
than 2 demonstration projects established under this section. Of those 
demonstration projects, the Secretary shall conduct at least one in an 
urban area and one in a rural area.
    (f) Duration.--The Secretary shall carry out the demonstration 
projects over a period of three years.
    (g) Evaluation and Report.--
            (1) Evaluations.--The Secretary shall conduct evaluations 
        of the clinical and cost effectiveness of the demonstration 
        projects.
            (2) Reports.--After the conclusion of the demonstration 
        projects under this section, the Secretary shall submit to 
        Congress a report on the evaluation, and shall include in the 
        report the following:
                    (A) An analysis of the patient outcomes and costs 
                of furnishing care to the medicare beneficiaries 
                participating in the projects as compared to such 
                outcomes and costs to other beneficiaries for the same 
                health conditions.
                    (B) Evaluation of patient satisfaction under the 
                demonstration projects.
                    (C) Such recommendations regarding the extension or 
                expansion of the projects as the Secretary determines 
                appropriate.
    (h) Waiver Authority.--The Secretary may waive such requirements of 
title XVIII of the Social Security Act as may be necessary for the 
purposes of carrying out the demonstration project.

A:
Medicare Chronic Kidney Disease Management Act of 2003 - Entitles qualified chronic kidney disease patients to benefits under part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act. Prohibits enrollment of chronic kidney disease patients in part C (Medicare+Choice) of the Social Security Act.

Provides for pre-end stage renal disease (pre-ESRD) professional nutritional and other counseling and related services and items for individuals diagnosed with chronic kidney disease.

Directs the Secretary of Health and Human Services to establish demonstration projects to evaluate methods through which kidney patient peer education may: (1) slow down or prevent the progress of kidney disease to end-stage renal disease in Medicare beneficiaries; (2) improve the management of co-morbid conditions associated with kidney disease; (3) improve choice in selection of renal replacement therapies (including home dialysis); and (4) improve other outcomes (such as employment).
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