,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #cafd  ,,in ,,the ,,house ,,of  
,,representatives  ,july #f1 #bjag,mrs4 
,black 7for herself1 ,ms4 ,del,bene1    
,mr4 ,thompson of ,california1 and ,mr4 
,meehan7 introduced the following bill2 
which was referred to the ,committee on 
,energy and ,commerce1 and in addition  
to the ,committee on ,ways and ,means1  
for a period to be subsequently         
determined by the ,speaker1 in each case
 for consideration of such provisions as
 fall within the jurisdiction of the    
committee concerned  ,a ,,bill  ,to     
amend title ,,xviii of the ,social      
,security ,act to expand access to home 
dialysis therapy4  #a4 ,expanding access
 to home dialysis therapy  7a7 ,allowing
 use of telehealth for monthly end stage
 renal disease-,related visits  7#a7 ,in
 general ,paragraph 7#c7 of section     
#ahha7;b7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #acierr7b77 is amended-- 
7,a7 by redesignating subparagraphs 7,a7
 and 7,b7 as clauses 7i7 and 7ii71      

respectively2  7,b7 in clause 7ii71 as  
redesignated by subparagraph 7,a7-- 7i7 
by inserting subject to subparagraph    
7,b71 before on a comprehensive2 and    
7ii7 by striking under this subparagraph
 and inserting under this clause2  7,c7 
by striking ,with respect to and        
inserting 7,a7 ,with respect to2 and    
7,d7 by adding at the end the following 
new subparagraph3  7,b7 7i7 ,subject to 
clause 7ii71 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 visits1 
furnished on or after ,january #a1      
#bjai1 via telehealth4  7ii7 ,clause 7i7
 shall apply to an individual only if   
the individual receives a face-to-face  
visit1 without the use of telehealth--  
7,i7 in the case of the initial three   
months of home dialysis of such         
individual1 at least monthly2 and       
7,,ii7 after such initial three months1 
at least once every three consecutive   

months4  4  7#b7 ,conforming amendment  
,paragraph 7#a7 of such section is      
amended by striking paragraph 7#c77;,a7 
and inserting paragraph 7#c77;,a77i74   
7b7 ,expanding originating sites for    
telehealth ,to include renal dialysis   
facilities and the home for purposes of 
monthly end stage renal disease-,related
 visits  7#a7 ,in general ,section      
#ahcd7m7 of the ,social ,security ,act  
7#db ,u4,s4,c4 #aciem7m77 is amended--  
7,a7 in paragraph 7#d77;,c77ii71 by     
adding at the end the following new     
subclauses3  7,,ix7 ,a renal dialysis   
facility1 but only for purposes of      
section #ahha7;b77#c77;,b74  7,x7 ,the  
home of an individual1 but only for     
purposes of section #ahha7;b77#c77;,b74 
2 and  7,b7 by adding at the end the    
following new paragraph3  7#e7          
,treatment of home dialysis monthly     
,,esrd-related visit ,the geographic    
requirements described in paragraph     
7#d77;,c77i7 shall not apply with       
respect to telehealth services furnished

 on or after ,january #a1 #bjai1 for    
purposes of section #ahha7;b77#c77;,b71 
at an originating site described in     
subclause 7,,vi71 7,,ix71 or 7,x7 of    
paragraph 7#d77;,c77ii774  4  7#b7 ,no  
facility fee if originating site for    
home dialysis therapy is the home       
,section #ahcd7m77#b77;,b7 of the       
,social ,security 7#db ,u4,s4,c4        
#aciem7m77#b77;,b77 is amended-- 7,a7 by
 redesignating clauses 7i7 and 7ii7 as  
subclauses 7,i7 and 7,,ii71             
respectively1 and by indenting each of  
such subclauses #b ems to the right2    
7,b7 in subclause 7,,ii71 as            
redesignated by subparagraph 7,a71 by   
striking clause 7i7 or this clause and  
inserting subclause 7,i7 or this        
subclause2  7,c7 by striking            
site4--,with respect to and inserting   
8site4--  7i7 ,in general ,subject to   
clause 7ii71 with respect to  2 and     
7,d7 by adding at the end the following 
new clause3  7ii7 ,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 7,x7 of paragraph             
7#d77;,c77ii74  4  7c7 ,clarification   
regarding telehealth provided to        
beneficiaries ,section #aabh;,a7i77#f7  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acbj;a-#g;a7i77#f77 is       
amended-- 7#a7 in subparagraph 7,h71 by 
striking 2 or and inserting a semicolon2
  7#b7 in subparagraph 7,i71 by striking
 the period at the end and inserting 2  
or2 and  7#c7 by adding at the end the  
following new subparagraph3  7,j7 the   
provision of telehealth on or after     
,january #a1 #bjai1 to individuals with 
end stage renal disease under title     
,,xviii by a health care provider for   
the purpose of furnishing of telehealth4
  4  7d7 ,study and report on further   
expansion  7#a7 ,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  
services1 pursuant to the amendments    
made by this section1 to include        
coverage of renal dialysis services     
furnished via telehealth and other      
store-and-forward technologies4  7#b7   
,report ,not later than two years after 
the date of the enactment of this ,act1 
the ,comptroller ,general shall submit  
to ,congress a report on the results of 
the study conducted under paragraph     
7#a74