,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #cafd  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #f1 #bjag,mrs4  
,black 7= h]self1 ,ms4 ,del,bene1 ,mr4  
,?ompson ( ,cali=nia1 & ,mr4 ,meehan7   
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 am5d title ,,xviii ( !     
,social ,security ,act to exp& access to
 home dialysis !rapy4  #a4 ,exp&+ access
 to home dialysis !rapy  7a7 ,all[+ use 
( teleheal? = mon?ly end /age r5al      
disease-,relat$ visits  7#a7 ,9 g5]al   
,p>agraph 7#c7 ( section #ahha7;b7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acierr7b77 is am5d$-- 7,a7 by          
r$esignat+ subp>agraphs 7,a7 & 7,b7 z   
clauses 7i7 & 7ii71 respectively2  7,b7 
9 clause 7ii71 z r$esignat$ by          
subp>agraph 7,a7-- 7i7 by ins]t+ subject

 to subp>agraph 7,b71 be=e on a         
compreh5sive2 &  7ii7 by /rik+ "u ?is   
subp>agraph & ins]t+ "u ?is clause2     
7,c7 by /rik+ ,) respect to & ins]t+    
7,a7 ,) respect to2 &  7,d7 by add+ at !
 end ! foll[+ new subp>agraph3  7,b7 7i7
 ,subject to clause 7ii71 an individual 
:o is det]m9$ to h end /age r5al disease
 & :o is receiv+ home dialysis may *oose
 to receive mon?ly end /age r5al        
disease-relat$ visits1 furni%$ on or    
aft] ,janu>y #a1 #bjai1 via teleheal?4  
7ii7 ,clause 7i7 %all apply to an       
individual only if ! individual receives
 a face-to-face visit1 )\t ! use (      
teleheal?--  7,i7 9 ! case ( ! initial  
?ree mon?s ( home dialysis ( su*        
individual1 at lea/ mon?ly2 &  7,,ii7   
aft] su* initial ?ree mon?s1 at lea/    
once e ?ree consecutive mon?s4  4  7#b7 
,con=m+ am5dm5t ,p>agraph 7#a7 ( su*    
section is am5d$ by /rik+ p>agraph      
7#c77;,a7 & ins]t+ p>agraph             
7#c77;,a77i74  7b7 ,exp&+ orig9at+ sites
 = teleheal? ,to include r5al dialysis  

facilities & ! home = purposes ( mon?ly 
end /age r5al disease-,relat$ visits    
7#a7 ,9 g5]al ,section #ahcd7m7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7m77 is am5d$--  7,a7 9 p>agraph  
7#d77;,c77ii71 by add+ at ! end ! foll[+
 new subclauses3  7,,ix7 ,a r5al        
dialysis facility1 b only = purposes (  
section #ahha7;b77#c77;,b74  7,x7 ,!    
home ( an individual1 b only = purposes 
( section #ahha7;b77#c77;,b74  2 &  7,b7
 by add+ at ! end ! foll[+ new p>agraph3
  7#e7 ,treatm5t ( home dialysis mon?ly 
,,esrd-relat$ visit ,! geographic       
requirem5ts describ$ 9 p>agraph         
7#d77;,c77i7 %all n apply ) respect to  
teleheal? s]vices furni%$ on or aft]    
,janu>y #a1 #bjai1 = purposes ( section 
#ahha7;b77#c77;,b71 at an orig9at+ site 
describ$ 9 subclause 7,,vi71 7,,ix71 or 
7,x7 ( p>agraph 7#d77;,c77ii774  4  7#b7
 ,no facility fee if orig9at+ site =    
home dialysis !rapy is ! home ,section  
#ahcd7m77#b77;,b7 ( ! ,social ,security 
7#db ,u4,s4,c4 #aciem7m77#b77;,b77 is   

am5d$-- 7,a7 by r$esignat+ clauses 7i7 &
 7ii7 z subclauses 7,i7 & 7,,ii71       
respectively1 & by ind5t+ ea* ( su*     
subclauses #b ems to ! "r2  7,b7 9      
subclause 7,,ii71 z r$esignat$ by       
subp>agraph 7,a71 by /rik+ clause 7i7 or
 ?is clause & ins]t+ subclause 7,i7 or  
?is subclause2  7,c7 by /rik+ site4--,) 
respect to & ins]t+ 8site4--  7i7 ,9    
g5]al ,subject to clause 7ii71 ) respect
 to  2 &  7,d7 by add+ at ! end ! foll[+
 new clause3  7ii7 ,no facility fee if  
orig9at+ site = home dialysis !rapy is !
 home ,no facility fee %all be paid "u  
?is subp>agraph to an orig9at+ site     
describ$ 9 subclause 7,x7 ( p>agraph    
7#d77;,c77ii74  4  7c7 ,cl>ification    
reg>d+ teleheal? provid$ to b5efici>ies 
,section #aabh;,a7i77#f7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#acbj;a-#g;a7i77#f77 is am5d$-- 7#a7 9  
subp>agraph 7,h71 by /rik+ 2 or & ins]t+
 a semicolon2  7#b7 9 subp>agraph 7,i71 
by /rik+ ! p]iod at ! end & ins]t+ 2 or2
 &  7#c7 by add+ at ! end ! foll[+ new  

subp>agraph3  7,j7 ! provision (        
teleheal? on or aft] ,janu>y #a1 #bjai1 
to individuals ) end /age r5al disease  
"u title ,,xviii by a heal? c>e provid] 
= ! purpose ( furni%+ ( teleheal?4  4   
7d7 ,/udy & report on fur!r expansion   
7#a7 ,/udy ,! ,comptroll] ,g5]al ( !    
,unit$ ,/ates %all conduct a /udy to    
exam9e ! b5efits & drawbacks ( exp&+ !  
cov]age "u ! ,m$ic>e program "u title   
,,xviii ( ! ,social ,security ,act (    
r5al dialysis s]vices z teleheal?       
s]vices1 pursuant to ! am5dm5ts made by 
?is section1 to include cov]age ( r5al  
dialysis s]vices furni%$ via teleheal? &
 o!r /ore-&-=w>d te*nologies4  7#b7     
,report ,n lat] ?an two ye>s aft] ! date
 ( ! enactm5t ( ?is ,act1 ! ,comptroll] 
,g5]al %all submit to ,congress a report
 on ! results ( ! /udy conduct$ "u      
p>agraph 7#a74