,i #aag? ,,congress #a/ ,session ,h4 ,r4 #edbf ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,septemb] #bi1 #bjba,mr4 ,ru% 7= himself & ,mr4 ,smi? ( ,miss\ri7 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 provide = ,m$ic>e cov]age ( /aff-assi/$ home dialysis = c]ta9 hemodialysis & p]itoneal dialysis pati5ts & to ensure all pati5ts are educat$ on modality options & receive ! res\rces1 in=mation1 & support to succe$ on ! modality ( _! *oice1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,improv+ ,access to ,home ,dialysis ,act ( #bjba4 #b4 ,provid+ = /aff-assi/$ home dialysis = c]ta9 hemodialysis & p]itoneal dialysis pati5ts 7a7 ,9 g5]al ,section #ahha7;b77#ad7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77#ad77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,j7 7i7 ,= s]vices furni%$ on or aft] ! date :i* is #a ye> aft] ! date ( ! enactm5t ( ?is subp>agraph :i* are /aff-assi/$ home dialysis 7z def9$ 9 clause 7iv77,,iii771 ! ,secret>y %all increase ! s+le paym5t t w\ld o!rwise apply "u ?is p>agraph = r5al dialysis s]vices furni%$ to new & respite individuals 9 accordance ) ! paym5t sy/em e/abli%$ "u clause 7iii7 by qualifi$ provid]s4 7ii7 7,i7 ,subject to subclause 7,,ii71 /aff-assi/$ home dialysis may only be furni%$ dur+-- 7aa7 ) respect to an individual describ$ 9 subclause 7iv77,i77aa71 "o #ij-;day p]iod :i* may be r5ew$ up to two #cj-;day p]iods2 & 7bb7 ) respect to an individual describ$ 9 subclause 7iv77,i77bb7 & not)/&+ :e!r su* an individual receives any respite c>e "u "p ,a1 any #cj-;day p]iod4 7,,ii7 ,not)/&+ ! limits describ$ 9 subclause 7,i71 /aff-assi/$ home dialysis may be furni%$ = z long z ! ,secret>y det]m9es appropriate to an individual :o-- 7aa7 is bl9d2 7bb7 has a cognitive or neurological impairm5t 7includ+ a /roke1 ,alzheim]'s1 dem5tia amyotrophic lat]al scl]osis1 or any o!r impairm5t det]m9$ by ! ,secret>y72 or 7cc7 has any o!r illness or injury t r$uces mobility 7includ+ c]ebral palsy1 sp9al cord injuries1 or any o!r illness or injury det]m9$ by ! ,secret>y74 7iii7 ,! ,secret>y %all e/abli% a prospective paym5t sy/em ?r\gh regulations to det]m9e ! am\nts payable to qualifi$ provid]s = /aff-assi/$ home dialysis4 ,9 e/abli%+ su* sy/em1 ! ,secret>y may consid]-- 7,i7 ! co/s ( furni%+ /aff-assi/$ home dialysis2 7,,ii7 consultations ) dialysis provid]s1 dialysis pati5ts1 private pay]s1 & ,,ma plans2 7,,iii7 paym5t am\nts = simil> items & s]vices "u p>ts ,a & ,b2 & 7,,iv7 paym5t am\nts e/abli%$ by ,,ma plans "u "p ,c1 gr\p heal? plans1 & heal? insurance cov]age (f]$ by heal? insurance issu]s4 7iv7 ,9 ?is subp>agraph3 7,i7 ,! t]m new & respite individual means an individual describ$ 9 subsection 7a7 :o is ei!r-- 7aa7 initiat+ ei!r p]itoneal or home hemodialysis2 or 7bb7 receiv+ home dialysis & is unable to self-dialyze due to illness1 injury1 c>egiv] issues1 or o!r tempor>y circum/ances4 7,,ii7 ,! t]m qualifi$ provid] means a tra9$ pr(essional 7z det]m9$ by ! ,secret>y1 includ+ nurses & c]tifi$ pati5t te*nicians7 :o furni%es r5al dialysis s]vices &-- 7aa7 meets requirem5ts 7z det]m9$ by ! ,secret>y7 t ensures compet5cy 9 pati5t c>e & modality usage2 & 7bb7 provides 9-p]son assi/ance to a pati5t = at lea/ #ge p]c5t ( /aff-assi/$ home dialysis sessions dur+ a p]iod describ$ 9 clause 7ii77i74 7,,iii7 7aa7 ,! t]m /aff-assi/$ home dialysis means home dialysis us+ tra9$ pr(essionals to assi/ individuals :o h be5 det]m9$ to h end /age r5al disease1 & ! frequ5cy ( su* home dialysis is det]m9$ by su* pr(essionals 9 coord9ation ) ! pati5t & 8 or h] c>e p>tn]1 & outl9$ 9 a pati5t plan ( c>e4 7bb7 ,9 ?is subclause1 ! t]m c>e p>tn] means anyone :o is designat$ by ! pati5t :o assi/s ! individual ) ! furni%+ ( home dialysis4 7cc7 ,9 ?is subclause1 ! t]m pati5t plan ( c>e has ! mean+ giv5 su* t]m 9 section #did4ij ( title #db1 ,code ( ,f$]al ,regulations4 4 7b7 ,pati5t education & tra9+ relat+ to /aff-,assi/$ home dialysis ,section #ahha7;b77#e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77#e77 is am5d$-- 7#a7 9 subp>agraph 7,c71 by /rik+ at ! end &2 7#b7 9 subp>agraph 7,d71 by /rik+ ! p]iod at ! end & ins]t+ a semicolon2 & 7#c7 by add+ at ! end ! foll[+ new subp>agraphs3 7,d7 educate pati5ts ( ! opportunity to receive /aff-assi/$ home dialysis 7z def9$ 9 p>agraph 7#ad77;,j77iv77,,iii77 dur+ ! p]iod beg9n+ #cj days aft] ! fir/ day su* facility furni%es r5al dialysis s]vices to an individual & end+ #fj days aft] su* day2 & 7,e7 provide = nurses1 c]tifi$ pati5t te*nicians1 or o!r pr(essionals to tra9 pati5ts & _! c>e p>tn]s 9 skills & proc$ures ne$$ to p]=m home dialysis 7z def9$ 9 p>agraph 7#ad77;,j77iv77,,iii77 treatm5t-- 7i7 regul>ly & indep5d5tly2 7ii7 ?r\gh teleheal? s]vices or ?r\gh gr\p tra9+ 7z describ$ 9 ! int]pretive guidance relat+ to tag numb] ,v#eij ( ,advance ,copy--,end ,/age ,r5al ,disease 7,,esrd7 ,program ,int]pretive ,guidance ,v]sion #a4a 7publi%$ on ,octob] #c1 #bjjh77 9 accordance ) ! ,f$]al regulations 7conc]n+ ! privacy ( individually id5tifiable heal? in=mation7 promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif2 & 7iii7 9 ! home or resid5t ( a pati5t1 9 a dialysis facility1 or ! place 9 :i* ! pati5t int5ds to receive /aff-assi/$ home dialysis4 4 7c7 ,o!r provisions 7#a7 ,anti-kickback /atute ,section #aabh;,b7b77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7b77#c77 is am5d$-- 7,a7 9 subp>agraph 7,j71 by /rik+ at ! end &2 7,b7 9 subp>agraph 7,k71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7,c7 by add+ at ! end ! foll[+ new subp>agraph3 7,l7 any remun]ation relat+ to ! furni%+ ( /aff-assi/$ home dialysis 7z def9$ 9 section #ahha7;b77#ad77;,j77iv77,,iii774 4 7#b7 ,,cmi model ,section #aaae;,a7b77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-7b77#b77;,b77 is am5d$ by add+ at ! end ! foll[+ new clause3 7xxviii7 ,mak+ paym5t to anyone :o is designat$ by a pati5t :o receives /aff-assi/$ home dialysis 7z def9$ 9 section #ahha7;b77#ad77;,j77iv77,,iii77 & o!rwise meets ! requirem5ts 7z det]m9$ by ! ,secret>y71 not)/&+ :e!r an individual is a qualifi$ provid] 7z def9$ 9 section #ahha7;b77#ad77;,j77iv77,,ii77 or o!rwise eligible = reimbursem5t "u title ,,xviii4 4 7#c7 ,/udy ,n lat] ?an #b ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all submit to ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & ! ,committee on ,f9ance ( ! ,s5ate a report t exam9es racial disp>ities 9 ! utilization ( ! home dialysis def9$ 9 section #ahha7;b77#ad77;,j77iv77,,iii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77#ad77;,j77iv77,,iii77 & make recomm5dations on h[ to improve access to su* dialysis = communities ( color4 7#d7 ,pati5t decision tool ,n lat] ?an ,decemb] #ca1 #bjbc1 = ! purpose ( section #ahha7;b77#ad77;,j7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77#ad77;,j771 ! ,secret>y ( ,heal? & ,human ,s]vices %all conv5e a pati5t panel to create a pati5t-c5t]$ decision tool = dialysis pati5ts to evaluate _! life/yle & goals & be assi/$ 9 *oos+ ! dialysis modality t be/ suits !m4 ,?is tool %\ld include an ackn[l$gm5t t !y are capable ( home dialysis & want home dialysis1 if t is ! modality !y *oose4 7#e7 ,pati5t quality ( life metric ,section #aaae;,a7b77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7i7 ,a pati5t quality ( life metric = all pati5ts utiliz+ dialysis reg>dless ( modality ) ! int5t ( measur+ & improv+ pati5t quality ( life on dialysis4 4