Teacher:In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
Teacher: Now, understand the problem? Solve this instance: 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.
Student:
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).