,i #aac? ,,congress #b;d ,session ,h4 ,r4 #dhad ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,june #i1 #bjad ,mr4 ,m>9o 7= himself & ,mr4 ,lewis7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to improve ! und]/&+ (1 & promote access to treatm5t =1 *ronic kidney disease1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,*ronic ,kidney ,disease ,improvem5t 9 ,rese>* & ,treatm5t ,act ( #bjad4 #b4 ,table ( cont5ts ,! table ( cont5ts ( ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title4 ,sec4 #b4 ,table ( cont5ts4 ,title ,i--,improv+ ,und]/&+ ( ,*ronic ,kidney ,disease ?r\gh ,exp&$ ,rese>* & ,coord9ation ,sec4 #aja4 ,id5tify+ gaps 9 *ronic kidney disease rese>*4 ,sec4 #ajb4 ,coord9at+ rese>* on *ronic kidney disease4 ,sec4 #ajc4 ,und]/&+ ! progression ( kidney disease & treatm5t ( kidney failure 9 m9ority populations4 ,title ,,ii--,promot+ ,access to ,*ronic ,kidney ,disease ,treatm5ts ,sec4 #bja4 ,increas+ access to ,m$ic>e kidney disease education b5efit4 ,sec4 #bjb4 ,improv+ access to *ronic kidney disease treatm5t 9 und]s]v$ rural & urban areas4 ,sec4 #bjc4 ,promot+ access to home dialysis treatm5ts4 ,sec4 #bjd4 ,exp& access = pati5ts ) acute kidney injury4 ,title ,,iii--,creat+ ,economic ,/ability = ,provid]s ,c>+ = ,individuals ) ,*ronic ,kidney ,disease ,sec4 #cja4 ,/abiliz+ ,m$ic>e paym5ts = s]vices provid$ to b5efici>ies ) /age ,v *ronic kidney disease receiv+ dialysis s]vices4 ,sec4 #cjb4 ,all[+ individuals ) kidney failure to reta9 access to private insurance4 ,sec4 #cjc4 ,provid+ individuals ) kidney failure access to manag$ c>e & coord9at$ c>e programs4 ,i ,improv+ ,und]/&+ ( ,*ronic ,kidney ,disease ?r\gh ,exp&$ ,rese>* & ,coord9ation #aja4 ,id5tify+ gaps 9 *ronic kidney disease rese>* 7a7 ,report ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all develop & submit to ! ,congress a compreh5sive report assess+ ! adequacy ( ,f$]al exp5ditures 9 *ronic kidney disease rese>* relative to ,f$]al exp5ditures = *ronic kidney disease c>e4 7b7 ,cont5ts ,! report requir$ by ?is section %all-- 7#a7 analyze ! curr5t *ronic kidney disease rese>* projects be+ fund$ by ,f$]al ag5cies2 7#b7 id5tify1 includ+ by survey+ ! kidney c>e community1 areas ( *ronic kidney disease k gaps t are n "p ( curr5t ,f$]al rese>* ef=ts2 7#c7 report on ! level ( ,f$]al exp5ditures on kidney rese>* z comp>$ to ! am\nt ( ,f$]al exp5ditures on treat+ individuals ) *ronic kidney disease2 & 7#d7 id5tify areas ( kidney failure k gaps 9 rese>* to assess treatm5t patt]ns associat$ ) provid+ c>e to m9ority populations t are disproportionately affect$ by kidney failure4 #ajb4 ,coord9at+ rese>* on *ronic kidney disease 7a7 ,int]ag5cy committee ,! ,secret>y ( ,heal? & ,human ,s]vices %all e/abli% & ma9ta9 an int]ag5cy committee = ! purpose ( improv+ ! coord9ation ( *ronic kidney disease rese>*4 7b7 ,reports ,= ! purpose describ$ 9 subsection 7a71 ! int]ag5cy committee e/abli%$ "u su* subsection %all issue public reports t-- 7#a7 include a /rategic plan1 includ+ recomm5dations =-- 7,a7 improv+ communication & coord9ation among ,f$]al ag5cies2 7,b7 proc$ures = monitor+ ,f$]al *ronic kidney disease rese>* activities2 & 7,c7 ways to maximize ! effici5cy ( ! ,f$]al *ronic kidney disease rese>* inve/m5t & m9imize ! pot5tial = unnecess>y duplication2 7#b7 include a portfolio analysis t provides in=mation on *ronic kidney disease rese>* projects1 organiz$ by ! /rategic plan objectives2 & 7#c7 address su* o!r topics z ! int]ag5cy committee det]m9es appropriate4 7c7 ,meet+s ,! int]ag5cy committee e/abli%$ "u subsection 7a7 %all meet n less ?an semi-annually4 #ajc4 ,und]/&+ ! progression ( kidney disease & treatm5t ( kidney failure 9 m9ority populations ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all-- 7#a7 complete a /udy on-- 7,a7 ! social1 behavioral1 & biological factors lead+ to kidney disease2 7,b7 ef=ts to sl[ ! progression ( kidney disease 9 m9ority populations t are disproportionately affect$ by su* disease2 & 7,c7 treatm5t patt]ns associat$ ) provid+ c>e1 "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act1 ! ,m$icaid program "u title ,,xix ( su* ,act1 & ?r\gh private heal? insurance1 to m9ority populations t are disproportionately affect$ by kidney failure2 & 7#b7 submit a report to ! ,congress on ! results ( su* /udy4 ,,ii ,promot+ ,access to ,*ronic ,kidney ,disease ,treatm5ts #bja4 ,increas+ access to ,m$ic>e kidney disease education b5efit 7a7 ,9 g5]al ,section #ahfa7;ggg7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7ggg77 is am5d$-- 7#a7 9 p>agraph 7#a7-- 7,a7 9 subp>agraph 7,a71 by ins]t+ or /age ,v aft] /age ,,iv2 7,b7 9 subp>agraph 7,b71 by ins]t+ or ( a physician assi/ant1 nurse practition]1 or cl9ical nurse speciali/ 7z def9$ 9 section #ahfa7;aa77#e77 assi/+ 9 ! treatm5t ( ! individual's kidney condition aft] kidney condition2 & 7#b7 9 p>agraph 7#b7-- 7,a7 by /rik+ subp>agraph 7,b72 & 7,b7 9 subp>agraph 7,a7-- 7i7 by /rik+ 7,a7 aft] 7#b72 7ii7 by /rik+ & at ! end ( clause 7i72 7iii7 by /rik+ ! p]iod at ! end ( clause 7ii7 & ins]t+ 2 &2 7iv7 by r$esignat+ clauses 7i7 & 7ii7 z subp>agraphs 7,a7 & 7,b71 respectively2 & 7v7 by add+ at ! end ! foll[+3 7,c7 a r5al dialysis facility subject to ! requirem5ts ( section #ahha7;b77#a7 ) p]sonnel :o-- 7i7 provide ! s]vices describ$ 9 p>agraph 7#a72 & 7ii7 is a physician 7z def9$ 9 subsection 7r77#a77 or a physician assi/ant1 nurse practition]1 or cl9ical nurse speciali/ 7z def9$ 9 subsection 7aa77#e774 4 7b7 ,paym5t to r5al dialysis facilities ,section #ahha7;b7 ( su* ,act 7#db ,u4,s4,c4 #acierr7b77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#ae7 ,= purposes ( p>agraph 7#ad71 ! s+le paym5t = r5al dialysis s]vices "u su* p>agraph %all n take into acc\nt ! am\nt ( paym5t = kidney disease education s]vices 7z def9$ 9 section #ahfa7;ggg774 ,in/ead1 paym5t = su* s]vices %all be made to ! r5al dialysis facility on an assignm5t-relat$ basis "u section #ahdh4 4 7c7 ,effective date ,! am5dm5ts made by ?is section apply to kidney disease education s]vices furni%$ on or aft] ,janu>y #a1 #bjae4 #bjb4 ,improv+ access to *ronic kidney disease treatm5t 9 und]s]v$ rural & urban areas 7a7 ,def9ition ( prim>y c>e s]vices ,section #cca7;a77#c77;,d7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,d77 is am5d$ by ins]t+ & includes r5al dialysis s]vices be=e ! p]iod at ! end4 7b7 ,national ,heal? ,s]vice ,corps ,s*ol>%ip ,program ,section #cch;,a7a77#b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bedl7a77#b77 is am5d$ by ins]t+ 1 includ+ nephrologi/s & non-physician practition]s provid+ r5al dialysis s]vices be=e ! p]iod at ! end4 7c7 ,national ,heal? ,s]vice ,corps ,loan ,repaym5t ,program ,section #cch;,b7a77#b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bedl-#a7;a77#b77 is am5d$ by ins]t+ 1 includ+ nephrologi/s & non-physician practition]s provid+ r5al dialysis s]vices be=e ! p]iod at ! end4 #bjc4 ,promot+ access to home dialysis treatm5ts 7a7 ,mon?ly capitation paym5ts ,not)/&+ any o!r provision ( law1 ) respect to dialysis s]vices furni%$ on or aft] ,janu>y #a1 #bjae1 ! ,secret>y ( ,heal? & ,human ,s]vices %all apply ) respect to visits by a physician provid$ )9 a mon? to an end /age r5al disease pati5t receiv+ dialysis s]vices at home1 ! alt]native ,m$ic>e bill+ proc$ures1 z describ$ 9 ! f9al rule promulgat$ by ! ,secret>y 9 ! ,f$]al ,regi/] on ,novemb] #g1 #bjjc 7#fh ,f$4 ,reg4 #fcbaf71 = physicians manag+ pati5ts on dialysis1 ) respect to visits by su* a physician provid$ )9 a mon? to an end /age r5al disease pati5t :o is hospitaliz$ dur+ ! mon?4 7b7 ,teleheal? ,section #ahcd7m77#d77;,c77ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c77ii77 is am5d$ by add+ at ! end ! foll[+ new subclause3 7,,ix7 ,a r5al dialysis facility 7z def9$ 9 section #ahha74 4 #bjd4 ,exp& access = pati5ts ) acute kidney injury ,section #ahha7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77 is am5d$-- 7#a7 9 p>agraph 7#a71 by ins]t+ or acute kidney injury aft] individuals :o h be5 det]m9$ to h end /age r5al disease2 7#b7 9 p>agraph 7#b77;,a71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 7#c7 9 p>agraph 7#b77;,b71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 7#d7 9 p>agraph 7#c71 9 ! matt] prec$+ subp>agraph 7,a71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 7#e7 9 p>agraph 7#aa77;,a71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 7#f7 9 p>agraph 7#aa77;,b71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 7#g7 9 p>agraph 7#ad77;,b7-- 7,a7 9 clause 7ii71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 7,b7 9 clause 7iii71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 & 7,c7 9 clause 7iv71 by ins]t+ or acute kidney injury aft] end /age r5al disease2 & 7#h7 9 p>agraph 7#ad77;,h77i71 by ins]t+ or acute kidney injury aft] end /age r5al disease4 ,,iii ,creat+ ,economic ,/ability = ,provid]s ,c>+ = ,individuals ) ,*ronic ,kidney ,disease #cja4 ,/abiliz+ ,m$ic>e paym5ts = s]vices provid$ to b5efici>ies ) /age ,v *ronic kidney disease receiv+ dialysis s]vices ,section #ahha7;b77#ad7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77#ad77 is am5d$-- 7#a7 9 subp>agraph 7,d71 9 ! matt] prec$+ clause 7i71 by /rik+ ,su* sy/em & ins]t+ ,subject to subp>agraph 7,j71 su* sy/em2 & 7#b7 by add+ at ! end ! foll[+ new subp>agraph3 7,j7 7i7 ,= paym5t = r5al dialysis s]vices furni%$ on or aft] ,janu>y #a1 #bjae1 "u ! sy/em "u ?is p>agraph-- 7,i7 ! paym5t adju/m5t describ$ 9 clause 7i7 ( subp>agraph 7,d7 %all n take into acc\nt comorbidities2 7,,ii7 ! paym5t adju/m5t describ$ 9 clause 7ii7 ( su* subp>agraph %all n be includ$2 7,,iii7 ! /&>dization factor describ$ 9 ! f9al rule publi%$ 9 ! ,f$]al ,regi/] on ,novemb] #h1 #bjab 7#gg ,f$4 ,reg4 #fgdgj71 %all be e/abli%$ us+ ! mo/ curr5tly available data 7& n hi/orical data7 & adju/$ on an annual basis1 bas$ on su* available data1 to acc\nt = any *ange 9 utilization ( drugs & any modification 9 adju/ors appli$ "u ?is p>agraph2 & 7,,iv7 ! ,secret>y %all take into acc\nt reasonable co/s consi/5t ) p>agraph 7#b77;,b7 :5 calculat+ su* paym5ts4 7ii7 ,n lat] ?an ,janu>y #a1 #bjae1 ! ,secret>y %all am5d ! ,,esrd facility co/ report to-- 7,i7 include ! p] treatm5t network fee 7z describ$ 9 p>agraph 7#g77 z an all[able co/2 & 7,,ii7 elim9ate ! limitation = report+ m$ical director fees on su* reports 9 ord] to take into acc\nt ! wages ( a bo>d-c]tifi$ nephrologi/4 4 #cjb4 ,all[+ individuals ) kidney failure to reta9 access to private insurance 7a7 ,9 g5]al ,section #ahfb7;b77#a77;,c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4#aciey7b77#a77;,c7 is am5d$-- 7#a7 9 ! la/ s5t5ce1 by ins]t+ & be=e ,janu>y #a1 #bjae aft] prior to su* date2 & 7#b7 by add+ at ! end ! foll[+ new s5t5ce3 ,effective = items & s]vices furni%$ on or aft] ,janu>y #a1 #bjae 7) respect to p]iods beg9n+ on or aft] ! date t is #db mon?s prior to su* date71 clauses 7i7 & 7ii7 %all be appli$ by sub/itut+ #db-mon? = #ab-mon? ea* place x appe>s44 7b7 ,effective date ,! am5dm5ts made by ?is subsection %all take effect on ! date ( enactm5t ( ?is ,act4 ,= purposes ( det]m9+ an individual's /atus "u section #ahfb7;b77#a77;,c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciey7b77#a77;,c771 z am5d$ by subsection 7a71 an individual :o is )9 ! coord9at+ p]iod z ( ! date ( enactm5t ( ?is ,act %all h t p]iod ext5d$ to ! full #db mon?s describ$ 9 ! la/ s5t5ce ( su* section1 z add$ by ! am5dm5t made by subsection 7a77#b74 #cjc4 ,provid+ individuals ) kidney failure access to manag$ c>e & coord9at$ c>e programs 7a7 ,exp&+ access to ,m$ic>e ,advantage 7#a7 ,eligibility "u ,m$ic>e ,advantage 7,a7 ,9 g5]al ,section #ahea7;a77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ba7;a77#c77 is am5d$-- 7i7 by /rik+ subp>agraph 7,b72 & 7ii7 by /rik+ eligible individual4-- & all t foll[s ?r\gh ,9 ?is title & ins]t+ eligible individual4--,9 ?is title4 7,b7 ,con=m+ am5dm5t ,section #aheb7;b77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bb7;b77#a77 is am5d$-- 7i7 by /rik+ subp>agraph 7,b72 & 7ii7 by /rik+ ,b5efici>ies4-- & all t foll[s ?r\gh ,a ,m$ic>e,*oice organization & ins]t+ ,b5efici>ies4--,a ,m$ic>e ,advantage organization4 7,c7 ,effective date ,! am5dm5ts made by ?is p>agraph %all apply ) respect to plan ye>s beg9n+ on or aft] ,janu>y #a1 #bjae4 7#b7 ,education ,section #ahea7;d77#b77;,a77iii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ba7;d77#b77;,a77iii77 is am5d$ by ins]t+ be=e ! p]iod at ! end ! foll[+ 1 includ+ any additional in=mation t individuals det]m9$ to h end /age r5al disease may ne$ to make in=m$ decisions ) respect to su* an election4 7#c7 ,quality metrics ,section #aheb7;e77#c77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bb7;e77#c77;,a77 is am5d$ by add+ at ! end ! foll[+ new clause3 7v7 ,requirem5ts ) respect to individuals ) ,,esrd ,9 addition to ! data requir$ to be collect$1 analyz$1 & report$ "u clause 7i7 & not)/&+ ! limitations "u subp>agraph 7,b71 z "p ( ! quality improvem5t program "u p>agraph 7#a71 ea* ,,ma organization %all provide = ! collection1 analysis1 & report+ ( data1 det]m9$ 9 consultation ) ! kidney c>e community1 t p]mits ! measurem5t ( heal? outcomes & o!r indices ( quality ) respect to individuals det]m9$ to h end /age r5al disease4 4 7b7 ,p]man5t ext5sion ( ,m$ic>e ,advantage ,,esrd ,special ,ne$s ,plans au?ority ,section #ahei7;f77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bh7;f77#a77 is am5d$ by ins]t+ 1 9 ! case ( a specializ$ ,,ma plan = special ne$s individuals :o h n be5 det]m9$ to h end /age r5al disease1 be=e = p]iods be=e ,janu>y #a1 #bjag4 7c7 ,volunt>y ,,esrd coord9at$ c>e ga9%>+ program 7#a7 ,9 g5]al ,section #ahha7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#ae7 7,a7 ,n lat] ?an ,janu>y #a1 #bjaf1 ! ,secret>y %all1 9 accordance ) ?is p>agraph1 e/abli% an ,,esrd ,c>e ,coord9ation ga9%>+ program = nephrologi/s1 r5al dialysis facilities1 & provid]s ( s]vices t develop coord9at$ c>e organizations to provide a full range ( cl9ical & supportive s]vices 7z describ$ 9 subp>agraph 7,d77 to individuals det]m9$ to h end /age r5al disease4 7,b7 ,"u su* program1 subject to subp>agraph 7,c71 ! paym5t am\nts r5al dialysis facilities & provid]s ( s]vices describ$ 9 subp>agraph 7,a7 w\ld o!rwise receive "u p>agraph 7#ad7 & nephrologi/s describ$ 9 subp>agraph 7,a7 w\ld o!rwise receive "u section #ahdh ) respect to dialysis s]vices furni%$ by su* a facility1 provid]1 or nephrologi/ dur+ a ye>1 %all be increas$ by a portion ( ! am\nt 7z det]m9$ by ! ,secret>y7 ( actual r$uctions 9 exp5diture "u ?is title attributable to ! coord9at$ c>e organization develop$ by su* facility1 provid]1 or nephrologi/ involv$1 tak+ into acc\nt non-dialysis exp5ditures "u p>ts ,a & ,b1 dur+ ! prec$+ cal5d> ye>4 ,! paym5t am\nt "u ?is subp>agraph %all be provid$ to a nephrologi/1 r5al dialysis facility1 & provid] ( s]vices t develop$ ! coord9at$ c>e organization no lat] ?an ,m>* #ca ( ! ye> aft] ! ye> dur+ :i* su* s]vices are provid$ by su* nephrologi/1 facility1 or provid]4 7,c7 ,! aggregate inc5tive paym5t am\nts provid$ "u su* program = a ye> may n exce$ ! am\nt equal to #b p]c5t less ?an ! e/imat$ total am\nt ( non-dialysis exp5ditures "u p>ts ,a & ,b = #bjaf = items & s]vices t are n relat$ to dialysis or transplant s]vices4 7,d7 ,= purposes ( subp>agraph 7,a71 ! full range ( cl9ical & supportive s]vices includes at lea/ ! foll[+3 7i7 ,prim>y c>e & o!r prev5tative s]vices4 7ii7 ,specialty c>e = co-morbidities or non-r5al acute conditions1 includ+ at lea/ podiatry1 c>diology1 & or?op$ics4 7iii7 ,vascul> access4 7iv7 ,laboratory te/+ & diagno/ic imag+4 7v7 ,ph>macy c>e managem5t4 7vi7 ,pati5t1 family1 & c>egiv] education4 7vii7 ,psy*iatric1 behavioral !rapy1 & c\nsel+ s]vices4 7,e7 ,9 provid+ paym5t inc5tive am\nts "u su* program1 ! ,secret>y %all apply a risk adju/m5t me?odology t-- 7i7 uses risk adju/] factors appli$ "u "p ,c2 & 7ii7 adju/s su* paym5ts to exclude ! top #b p]c5t ( outli]s4 7,f7 ,9 e/abli%+ su* program1 ! ,secret>y %all ensure t ea* ( ! foll[+ is satisfi$3 7i7 ,! program all[s = all types & sizes ( r5al dialysis facilities & provid]s ( s]vices describ$ 9 subp>agraph 7,a71 includ+ pr(it & n-=-pr(it1 urban & rural1 z well z all o!r types & sizes ( su* facilities & provid]s1 to p>ticipate4 7ii7 ,! program rew>ds high quality1 effici5t facilities & provid]s ?r\gh ga9-%>+4 7iii7 ,= purposes ( det]m9+ ! actual r$uctions 9 exp5ditures "u ?is title attributable to a coord9at$ c>e organization describ$ 9 subp>agraph 7,a71 ! program includes a m>ket-bas$ b5*m>k sy/em t w n be rebas$ aga9/ :i* su* exp5ditures %all be comp>$4 7iv7 ,! program results 9 r$uctions ( exp5ditures "u p>ts ,a & ,b = s]vices t are n dialysis-relat$ s]vices4 7v7 ,! program all[s new applicants to p>ticipate 9 ! program aft] ! initial implem5tation p]iod4 7vi7 ,! program e/abli%es cle> quality metrics 9 consultation ) ! kidney c>e community4 7vii7 ,! program provides = waiv]s ( ,f$]al laws or requirem5ts1 9 consultation ) int]e/$ /akehold]s4 7viii7 ,"u su* program ! ,secret>y attributes individuals describ$ 9 subp>agraph 7,a7 :o receive treatm5t ?r\gh a c>e coord9ation organization describ$ 9 su* subp>agraph to su* organization r ?an to any o!r paym5t model t requires b5efici>y attribution4 7ix7 ,"u su* program ! ,secret>y provides qu>t]ly ,m$ic>e p>ts ,a & ,b claims data to facilities & provid]s describ$ 9 subp>agraph 7,a7 p>ticipat+ 9 su* program4 7,g7 ,n lat] ?an ?ree ye>s aft] ! date ( ! implem5tation ( ! ,,esrd ,c>e ,coord9ation ga9%>+ program1 ! ,secret>y %all submit to ! ,congress a report on ! waiv]s grant$ "u subp>agraph 7,f77vii7 & ! effectiv5ess ( su* waiv]s 9 all[+ ! coord9ation ( c>e4 4 7#b7 ,con=m+ am5dm5ts 7,a7 ,section #ahha ,section #ahha7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77 is am5d$-- 7i7 9 ea* ( p>agraphs 7#ab77;,a7 & 7#ac77;,a71 by /rik+ p>agraph 7#ad7 & ins]t+ p>agraphs 7#ad7 & 7#ae72 & 7ii7 9 p>agraph 7#ad77;,a77i71 by ins]t+ & p>agraph 7#ae7 aft] ,subject to subp>agraph 7,e74 7,b7 ,section #ahdh ,section #ahdh ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7q7 ,volunt>y ,,esrd coord9at$ c>e program ,= provisions relat$ to inc5tive paym5t am\nts to nephrologi/s "u ! ,,esrd ,c>e ,coord9ation ga9%>+ program1 see section #ahha7;b77#ae74 4 7d7 ,pati5t in=mation requirem5t ,! ,secret>y ( ,heal? & ,human ,s]vices %all require hospitals t furni% items & s]vices to individuals entitl$ to b5efits "u "p ,a ( title ,,xviii ( ! ,social ,security ,act or eligible = b5efits "u "p ,b ( su* title & :o subsequ5tly receive dialysis s]vices at a r5al dialysis facility 7z def9$ 9 section #ahha ( su* ,act 7#db ,u4,s4,c4 #acierr77 to provide to su* facility heal? in=mation ) respect to su* individual1 includ+ a dis*>ge summ>y & co-morbidity in=mation1 ^u reque/ ( ! facility1 n lat] ?an #g days aft] notification by ! hospital ( ! provision ( su* s]vices to su* individual or ( ! det]m9ation t su* individual has end /age r5al disease1 z applicable4