,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #gejf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #ad1 #bjbb ,mr4
 ,butt]field 7= himself & ,mr4          
,bilirakis7 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 ! ,public  
,heal? ,s]vice ,act ) respect to prev5t+
 end-/age kidney disease1 & = o!r       
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,new ,era ( ,prev5t+       
,end-,/age ,kidney ,disease ,act4  #b4  
,table ( cont5ts ,! table ( cont5ts (   
?is ,act is z foll[s3  ,sec4 #a4 ,%ort  
title4 ,sec4 #b4 ,table ( cont5ts4 ,sec4
 #c4 ,f9d+s4 ,sec4 #d4 ,def9itions4     
,title ,i--,c5t]s ( excell5ce & r>e     
kidney disease rese>* ,sec4 #aja4       
,,niddk ,c5t]s on ,r>e ,kidney ,disease 
,rese>*4 ,sec4 #ajb4 ,r>e kidney disease

 progression rese>*4 ,title             
,,ii--,diagno/ics ,sec4 #bja4 ,diagno/ic
 issues relat+ to r>e kidney disease4   
,title ,,iii--,communities ( ,color     
,sec4 #cja4 ,und]/&+ & sl[+ !           
progression ( r>e kidney disease &      
treatm5t 9 c]ta9 populations4 ,sec4     
#cjb4 ,communities ( color s]vice       
program4 ,sec4 #cjc4 ,,nih report on    
,,nih rese>* programs4 ,sec4 #cjd4      
,p>tn]%ips ) organizations & ag5cies4   
,title ,,iv--,provid] ,education ,sec4  
#dja4 ,prim>y c>e provid] tra9+ grant   
program4 ,sec4 #djb4 ,grant program =   
developm5t & implem5tation ( curricula =
 cont9u+ education on kidney disease4   
,title ,v--,cov]age & exp]im5ts to r$uce
 dialysis & transplant co/s ,sec4 #eja4 
,m$ical exp]tise 9 ph>macy & !rapeutic  
committees4 ,sec4 #ejb4 ,r$uc+ dialysis 
& transplant co/s relat$ to r>e kidney  
disease4  #c4 ,f9d+s ,congress f9ds !   
foll[+3 7#a7 ,approximately #cg1jjj1jjj 
adults 9 ! ,unit$ ,/ates h a *ronic     
kidney disease1 & kidney diseases are ! 

n9? lead+ cause ( dea? 9 ! ,unit$       
,/ates4  7#b7 ,ea* day 9 ! ,unit$       
,/ates1 on av]age1 #cdj p beg9 dialysis 
& #ac p die wait+ = a kidney transplant4
  7#c7 ,r>e kidney diseases l focal     
segm5tal glom]uloscl]osis &             
immunoglobul9 ,a nephropa?y are         
p>ticul>ly difficult to treat1 & !re are
 no approv$ treatm5ts = ^! diseases4    
7#d7 ,9 ! abs5ce ( approv$ treatm5t     
options1 m ?an #ajj1jjj p live ) r>e    
glom]ul> kidney disease & face dialysis1
 transplant1 or dea?4  7#e7 ,focal      
segm5tal glom]uloscl]osis is associat$ )
 a #ej p]c5t risk ( end-/age kidney     
disease )9 #e ye>s ( diagnosis if p>tial
 or complete remission is n a*iev$4     
7#f7 ,betwe5 #bj & #dj p]c5t (          
individuals ) immunoglobul9 ,a          
nephropa?y are expect$ to develop       
end-/age kidney disease )9 #bj ye>s4    
7#g7 ,r>e kidney diseases               
disproportionately affect ,black        
,am]icans1 :o are #c4e times m likely to
 develop end-/age kidney disease1 & #e  

times m likely ?an ! g5]al population to
 h focal segm5tal glom]uloscl]osis4     
7#h7 ,because approximately "o-?ird (   
,black ,am]icans ) focal segm5tal       
glom]uloscl]osis cases are associat$ ) a
 p>ticul> g5e1 communities ( color w\ld 
b5efit f additional res\rces to support 
e>li] detection1 includ+ g5etic & g5omic
 te/+ & ref]rals to high-quality        
provid]s4  7#i7 ,! preval5ce ( end-/age 
kidney disease is exac]bat$ by diagno/ic
 *all5ges1 b>ri]s to high-quality c>e1 &
 lack ( aw>5ess ( disease risks4  7#aj7 
,f$]al sp5d+ on end-/age kidney disease 
curr5tly acc\nts = approximately #g     
p]c5t ( ,f$]al ,m$ic>e sp5d+4  7#aa7 ,! 
total ,m$ic>e sp5d+ on bo? *ronic kidney
 disease & end-/age kidney disease      
pati5ts exce$$ #abj1jjj1jjj1jjj p] ye> 9
 rec5t ye>s4  7#ab7 ,a focus on r5al    
heal? & ! prev5tion ( end-/age kidney   
disease w\ld improve pati5t outcomes1   
ext5d lives1 mitigate racial heal? c>e  
disp>ities1 & r$uce gov]nm5t sp5d+4     
7#ac7 ,due 9 l>ge "p to ! #ba/ ,c5tury  

,cures ,act1 new regulatory p>adigms h  
unlea%$ a wave ( cl9ical innovation 9 ! 
r>e kidney disease space4  7#ad7 ,9     
#bjbj1 ! fir/-ev] ,r>e ,kidney ,disease 
,r\ndtable outl9$ urg5t ne$s 9 ! areas (
 diagnosis1 education1 communities (    
color1 & pati5t support = r>e kidney    
disease pati5ts & _! families 9 ! ,unit$
 ,/ates4  7#ae7 ,9 #bjba1 !re are ov]   
#cj ongo+ cl9ical trials und]way =      
treatm5ts = a range ( r>e kidney        
diseases1 (f]+ ! fir/ hope = novel      
!rapies = pati5ts liv+ ) r>e kidney     
diseases1 a new era ( prev5t+ end-/age  
kidney disease & relat$ ,f$]al co/s1 & !
 possibility ( improv+ *ronic kidney c>e
 writ l>ge4  #d4 ,def9itions ,9 ?is     
,act3 7#a7 ,director ( ,,nih ,! t]m     
,director ( ,,nih means ! ,director ( ! 
,national ,in/itutes ( ,heal?4  7#b7    
,,nih ,! t]m ,,nih means ! ,national    
,in/itutes ( ,heal?4  7#c7 ,secret>y ,! 
t]m ,secret>y means ! ,secret>y ( ,heal?
 & ,human ,s]vices4  ,i ,c5t]s (        
excell5ce & r>e kidney disease rese>*   

#aja4 ,,niddk ,c5t]s on ,r>e ,kidney    
,disease ,rese>* ,subp>t #c ( "p ,c (   
title ,,iv ( ! ,public ,heal? ,s]vice   
,act 7#db ,u4,s4,c4 #bha et seq47 is    
am5d$ by ins]t+ aft] section #dbf 7#db  
,u4,s4,c4 #bhe;c7 ! foll[+ new section3 
#dbf;,a4 ,,niddk ,c5t]s on ,r>e ,kidney 
,disease ,rese>*  7a7 ,coop]ative       
agreem5ts & grants  7#a7 ,9 g5]al ,!    
,director ( ! ,in/itute may ent] into   
coop]ative agreem5ts )1 & make grants   
to1 public & private nonpr(it entities  
to pay all or "p ( ! co/ ( plann+1      
e/abli%+1 or /r5g!n+1 & provid+ basic   
op]at+ support =1 regional c5t]s (      
excell5ce = r>e kidney diseases1 includ+
 prim>y glom]ul> disease4 ,su* c5t]s (  
excell5ce %all be kn[n z ,,niddk ,c5t]s 
on ,r>e ,kidney ,disease ,rese>*4  7#b7 
,purposes ( c5t]s ,! purposes ( ! c5t]s 
( excell5ce fund$ pursuant to p>agraph  
7#a7 %all be-- 7,a7 to increase public  
aw>5ess ( r>e kidney diseases1          
p>ticul>ly 9 communities ( color2 &     
7,b7 to develop res\rces = cl9ical      

rese>* into1 tra9+ 91 & demon/ration (  
diagno/ic1 prev5tion1 control1 &        
treatm5t me?ods =1 r>e kidney diseases4 
7#c7 ,policies ,a coop]ative agreem5t or
 grant "u p>agraph 7#a7 %all be ent]$   
into 9 accordance ) policies e/abli%$ by
 ! ,director ( ! ,national ,in/itutes ( 
,heal?4  7b7 ,coord9ation ) o!r         
in/itutes ,! ,director ( ! ,in/itute    
%all coord9ate ! activities "u ?is      
section ) simil> activities t are relat$
 to r>e kidney disease & conduct$ by o!r
 national rese>* in/itutes1 c5t]s1 &    
ag5cies ( ! ,national ,in/itutes (      
,heal? & by ! ,food & ,drug             
,adm9i/ration4  7c7 ,uses = ,f$]al      
paym5ts "u coop]ative agreem5ts or      
grants ,f$]al paym5ts made "u a         
coop]ative agreem5t or grant "u         
subsection 7a7 may be us$ =--  7#a7     
basic op]at+ co/s1 includ+ su* pati5t   
c>e co/s z are requir$ = rese>*2  7#b7  
cl9ical tra9+1 includ+ tra9+ = alli$    
heal? pr(essionals1 cont9u+ education = 
heal? pr(essionals & alli$ heal?        

pr(essions p]sonnel1 & in=mation        
programs = ! public ) respect to r>e    
kidney diseases2  7#c7 cl9ical rese>* & 
demon/ration programs2  7#d7 education (
 memb]s ( ! public1 p>ticul>ly ?r\gh    
outrea* to communities ( color1 on !    
diagnosis 7includ+ ?r\gh r\t9e ur9alysis
 & ?r\gh g5etic te/+71 prev5tion1       
control1 & treatm5t ( r>e kidney        
diseases2 &  7#e7 education (           
individuals diagnos$ ) r>e kidney       
diseases on r5al diet & life/yle1 g5etic
 te/+1 & programs to promote ur9alysis1 
& on m5tal & emotional heal? res\rces = 
families ( r>e kidney disease pati5ts4  
7d7 ,p]iod ( support2 additional p]iods 
,! p]iod ( support = a c5t] ( excell5ce 
"u subsection 7a7 may n exce$ #e ye>s1  
except t su* p]iod may be ext5d$ by !   
,director ( ! ,in/itute = additional    
p]iods ( n m ?an #e ye>s = ea* c5t] if--
  7#a7 ! op]ations ( su* c5t] h be5     
review$ by an appropriate te*nical &    
sci5tific pe] review gr\p e/abli%$ by ! 
,director ( ! ,in/itute2 &  7#b7 su*    

gr\p has recomm5d$ to ! ,director ( !   
,in/itute t su* p]iod %\ld be ext5d$4   
7e7 ,au?orization ( appropriations ,to  
c>ry out ?is section1 !re is au?oriz$ to
 be appropriat$ #d1jjj1jjj = ea* (      
fiscal ye>s #bjbc ?r\gh #bjbg4  4  #ajb4
 ,r>e kidney disease progression rese>* 
7a7 ,,nih rese>* on r>e kidney diseases 
,! ,director ( ,,nih may aw>d grants or 
contracts to public & nonpr(it private  
entities to conduct rese>* on ! causes1 
etiology1 symptoms1 diagnosis1          
progression1 & treatm5t ( r>e kidney    
diseases1 includ+ glom]ul> diseases4    
7b7 ,application ,to seek a grant "u ?is
 section1 an eligible entity %all submit
 an application 9 su* =m1 9 su* mann]1 &
 conta9+ su* agreem5ts1 assurances1 &   
in=mation z ! ,director ( ,,nih det]m9es
 to be necess>y4  7c7 ,rese>* fund$     
,rese>* fund$ ?r\gh a grant "u ?is      
section--  7#a7 may n include any       
consid]ation ( quality-adju/$ life ye>s 
or disability-adju/$ life ye>s1 or o!r  
simil> me*anisms t discrim9ate aga9/ p )

 disabilities 9 value & co/-effectiv5ess
 assessm5ts2  7#b7 %all include p]sons (
 color 9 populations /udi$ 9 ! rese>*2 &
  7#c7 %all include /udy (              
g5otype-ph5otype relation to disease    
progression4  7d7 ,au?orization (       
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#a1jjj1jjj = ea* ( fiscal ye>s #bjbc    
?r\gh #bjbg4  ,,ii ,diagno/ics  #bja4   
,diagno/ic issues relat+ to r>e kidney  
disease  7a7 ,conf]5ce  7#a7 ,9 g5]al ,!
 ,secret>y %all1 n lat] ?an #ab mon?s   
aft] ! date ( ! enactm5t ( ?is ,act1    
conv5e a conf]5ce to-- 7,a7 analyze !   
impact ( ! decl9e ( r\t9e ur9alysis on !
 timely diagnosis ( r>e kidney disease &
 on ! quality ( pati5t c>e foll[+ a     
diagnosis ( su* disease2  7,b7 analyze !
 quality & reliability ( kidney biopsy 9
 ! diagnosis ( r>e kidney disease2  7,c7
 analyze ! impact ( g5etic & g5omic te/+
 on prev5tative c>e & precision m$ic9e )
 respect to r>e kidney disease2  7,d7   
recomm5d /rategies to r$uce disp>ities 9

 ! occurr5ce & treatm5t ( r>e kidney    
disease among diff]5t gr\ps1 includ+    
communities ( color2 &  7,e7 recomm5d   
/rategies to increase r\t9e ur9alysis & 
to improve te*nologies to diagnose su*  
disease1 includ+ g5etic te/+4  7#b7     
,consultation ,9 c>ry+ out p>agraph     
7#a71 ! ,secret>y %all consult )        
relevant /akehold]s1 includ+ heal? c>e  
provid]s1 m$ical pr(essional societies1 
,/ate-bas$ societies1 public heal?      
exp]ts1 ,/ate & local public heal?      
dep>tm5ts1 ,/ate m$ical bo>ds1 pati5t   
gr\ps1 drug manufactur]s1 ph>maci/s1    
insur]s1 & o!r entities ) exp]i5ce 9    
heal? c>e1 public heal?1 & r>e disease1 
z appropriate4  7b7 ,e>ly int]v5tion on 
g5etic scre5+  7#a7 ,/udy ,! ,secret>y  
%all conduct a /udy on--  7,a7 :e!r     
g5etic & g5omic te/+ may improve        
prev5tative c>e & precision m$ic9e )    
respect to r>e kidney disease2  7,b7    
:e!r g5etic & g5omic te/+1 & 9 p>ticul> 
te/+ ( ! ,,apol#a g5e1 may r$uce        
disp>ities 9 ! occurr5ce & treatm5t (   

r>e kidney disease among diff]5t gr\ps1 
includ+ communities ( color2  7,c7 :e!r 
! ,f$]al ,gov]nm5t may help to r$uce    
b>ri]s to g5etic & g5omic te/+ = r>e    
kidney disease1 includ+ by-- 7i7        
enc\rag+ ! expansion ( heal? insurance  
cov]age ( g5etic & g5omic te/+1 includ+ 
diagno/ic1 pr$ictive1 & presymptomatic  
te/+1 & ,,dna sequ5c+ cl9ical s]vices2  
7ii7 support+ ! collection ( evid5ce = !
 cl9ical utility & appropriate use (    
g5etic & g5omic te/s2 &  7iii7 improv+  
access to g5etic c\nselors1 pa?ologi/s1 
& o!r relevant pr(essions1 includ+      
/r5g!n+ relat$ work=ce education & tra9+
 ef=ts2  7,d7 ! ext5t to :i* cov]age    
provisions 9 ! ,m$ic>e & ,m$icaid       
programs "u titles ,,xviii & ,,xix ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq41 #acif et seq47 may re/ra9
 ! use ( g5etic & g5omic te/+ = r>e     
kidney disease t may improve cl9ical    
outcomes = b5efici>ies2  7,e7 :e!r !    
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices may 
make cov]age det]m9ations t bett] suit a

 precision m$ic9e approa* to treatm5t2 &
  7,f7 :e!r g5etic & g5omic te/+ may    
improve heal? outcomes = individuals )  
r>e kidney disease4  7#b7 ,report  7,a7 
,9 g5]al ,n lat] ?an #ah mon?s aft] !   
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all submit a report to !     
,congress on ! proce$+s ( ! conf]5ce "u 
subsection 7a7 & ! results ( ! /udy "u  
p>agraph 7#a74  7,b7 ,consultation ,9   
conduct+ ! /udy "u p>agraph 7#a7 &      
develop+ ! report requir$ by subp>agraph
 7,a71 ! ,secret>y %all consult )       
physicians1 o!r heal? pr(essionals1     
heal? educators1 heal? pr(essional      
organizations1 relevant companies1      
pati5ts1 pati5t organizations1 ! ,heal? 
,res\rces & ,s]vices ,adm9i/ration1 !   
,director ( ,,nih1 ! ,national ,in/itute
 ( ,diabetes & ,dige/ive & ,kidney      
,diseases1 & ! ,c5t]s = ,m$ic>e         
,m$icaid ,s]vices4 ,su* consultation    
%all include consultation activities    
conduct$ z "p ( ! conf]5ce "u subsection
 7a74  7#c7 ,def9ition ,9 ?is           

subsection1 ! t]m ,,dna sequ5c+ cl9ical 
s]vices1 ) respect to an individual--   
7,a7 means a det]m9ation ( an exact     
sequ5ce ( deoxyribonucleic acid bases 9 
! g5ome ( su* individual1 &1 if = ! sole
 b5efit ( ! individual1 a biological    
p>5t ( su* individual = ! purpose (     
det]m9+ :e!r "o or m pot5tially         
disease-caus+ g5etic v>iants are pres5t 
9 ! g5ome ( su* individual or su*       
biological p>5t2 &  7,b7 includes--  7i7
 sequ5c+ ( ! entire g5ome1 ( ! exome1 ( 
a panel ( g5es1 or o!r regions ( !      
g5ome2 &  7ii7 any analysis1            
int]pretation1 & data report d]iv$ f su*
 sequ5c+4  7c7 ,au?orization (          
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#e1jjj1jjj = ! p]iod ( fiscal ye>s #bjbc
 ?r\gh #bjbg4  ,,iii ,communities (     
,color  #cja4 ,und]/&+ & sl[+ !         
progression ( r>e kidney disease &      
treatm5t 9 c]ta9 populations  7a7 ,/udy 
,! ,secret>y %all conduct a /udy on--   
7#a7 ! social1 behavioral1 & biological 

factors lead+ to r>e kidney disease2    
7#b7 treatm5t patt]ns associat$ )       
provid+ c>e1 "u ! ,m$ic>e program "u    
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq471 !       
,m$icaid program "u title ,,xix ( su*   
,act 7#db ,u4,s4,c4 #acif et seq471 &   
?r\gh private heal? insurance1 to       
populations t are disproportionately    
affect$ by su* disease2  7#c7 access to 
nephrologi/s among populations t are    
disproportionately affect$ by su*       
disease2  7#d7 ongo+ ef=ts &            
recomm5dations to sl[ ! progression (   
end-/age kidney disease 9 populations t 
are disproportionately affect$ by r>e   
kidney disease2 &  7#e7 pati5t tru/ (   
treat+ provid]s among populations t are 
disproportionately affect$ by su*       
disease4  7b7 ,report ,n lat] ?an #a ye>
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,secret>y %all submit to ! ,congress a  
report on ! /udy conduct$ "u subsection 
7a71 toge!r ) su* recomm5dations z !    
,secret>y det]m9es to be appropriate4   

7c7 ,coord9ation ,9 c>ry+ out !         
activities "u subsections 7a7 & 7b71 !  
,secret>y %all coord9ate ) ! ,director (
 ,,nih1 ! ,adm9i/rator ( ! ,c5t] =      
,m$ic>e  ,m$icaid ,s]vices1 !           
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 & ! ,director ( 
! ,c5t] = ,m$ic>e & ,m$icaid            
,innovation4  7d7 ,consultation ,9 c>ry+
 out ! activities "u subsections 7a7 &  
7b71 ! ,secret>y %all consult ) relevant
 /akehold]s1 includ+ heal? c>e provid]s1
 m$ical pr(essional societies1          
,/ate-bas$ societies1 public heal?      
exp]ts1 ,/ate & local public heal?      
dep>tm5ts1 ,/ate m$ical bo>ds1 pati5t   
gr\ps1 drug manufactur]s1 ph>maci/s1    
insur]s1 & o!r entities ) exp]i5ce 9    
heal? c>e1 public heal?1 heal? equity1 &
 r>e disease1 z appropriate4  #cjb4     
,communities ( color s]vice program     
,section #gcf7;b7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4 #bic7 is    
am5d$-- 7#a7 by r$esignat+ p>agraph 7#g7
 z p>agraph 7#h72  7#b7 9 p>agraph      

7#f77;,b71 by /rik+ 2 & & ins]t+ a      
semicolon2 &  7#c7 by ins]t+ aft]       
p>agraph 7#f7 ! foll[+3  7#g7 to aw>d   
fell[%ips1 :i* may include /ip5ds1 =    
po/graduate tra9+ 9 ! field (           
nephrology1 = ! purposes (-- 7,a7       
increas+ provid]s' k ( issues relat$ to 
prev5tion1 diagnosis1 & treatm5t ( r>e  
kidney disease among racial & e?nic     
m9ority populations1 especially !       
preval5ce ( ! g5e ,,apol#a2  7,b7       
improv+ ! quality ( r>e kidney disease  
prev5tion1 diagnosis1 & treatm5t deliv]$
 to racial & e?nic m9orities2 &  7,c7   
increas+ ! numb] ( culturally compet5t  
nephrologi/s2 &  4  #cjc4 ,,nih report  
on ,,nih rese>* programs ,! ,director ( 
,,nih %all prep>e & publi% on ! public  
website ( ! ag5cy a report on div]sity  
)9 ! programs ( ! ,,nih to rese>* kidney
 disease1 includ+-- 7#a7 ! div]sity (   
recipi5ts ( rese>* grants2 &  7#b7 !    
ext5t to :i* grants are aw>d$ to rese>* 
kidney disease among communities (      
color1 includ+ disp>ities 9 ! prev5tion1

 diagnosis1 & treatm5t ( kidney disease 
among racial & e?nic m9ority            
populations4  #cjd4 ,p>tn]%ips )        
organizations & ag5cies  7a7 ,,hhs      
program ,"u ?is section or o!r          
applicable provisions ( law1 ! ,secret>y
 %all e/abli% a program to provide      
grants to eligible entities to provide  
education & appropriate m$ical & o!r    
ref]rals = pati5ts 9 communities ( color
 reg>d+ kidney disease1 includ+ r>e     
kidney disease4  7b7 ,eligibility ,to be
 eligible to receive a grant "u ?is     
section1 an entity %all-- 7#a7 be--     
7,a7 a nonpr(it or community-bas$       
organization1 includ+ any community     
heal? c5t]2 or  7,b7 a ,/ate or local   
gov]nm5tal ag5cy2 &  7#b7 submit to !   
,secret>y an application-- 7,a7 at su*  
"t & 9 su* mann] z ! ,secret>y may      
require2 &  7,b7 conta9+-- 7i7 a        
description ( h[ ! applicant proposes to
 use ! grant funds2 &  7ii7 su* o!r     
in=mation z ! ,secret>y may require4    
7c7 ,report+  7#a7 ,by grantee ,a       

recipi5t ( a grant "u ?is section %all  
submit annually to ! ,secret>y1 & make  
publicly available1 a report on !       
activities conduct$ us+ funds receiv$   
?r\gh ! grant4  7#b7 ,by ,secret>y ,n   
lat] ?an ! end ( fiscal ye> #bjbf1 !    
,secret>y %all submit to ! ,congress a  
report t includes-- 7,a7 a summ>y ( !   
reports receiv$ "u p>agraph 7#a72  7,b7 
an evaluation ( ! effectiv5ess ( grants 
aw>d$ "u ?is section2 &  7,c7 any       
recomm5dations ! ,secret>y may h4  7d7  
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ #b1jjj1jjj = ea* ( fiscal   
ye>s #bjbc ?r\gh #bjbg4  ,,iv ,provid]  
,education  #dja4 ,prim>y c>e provid]   
tra9+ grant program ,subp>t ,i ( "p ,c (
 title ,,vii ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bick et seq47 is   
am5d$ by ins]t+ aft] section #gdg;,a    
7#db ,u4,s4,c4 #bick-#a7 ! foll[+3      
#gdg;,b4 ,r>e kidney disease tra9+ =    
prim>y c>e provid]s  7a7 ,9 g5]al ,!    
,secret>y may make grants to an accr$it$

 public or nonpr(it private hospital1   
s*ool ( m$ic9e1 or academically         
affiliat$ physician assi/ant tra9+      
program1 to a public or private nonpr(it
 entity t ! ,secret>y has det]m9$ is    
capable ( c>ry+ out su* grant1 or to any
 consortium ( su* hospitals1 s*ools1    
programs1 or entities1 to plan1 develop1
 & op]ate a pr(essional tra9+ program 9 
! field ( nephrology = prim>y c>e       
resid5ts1 physicians1 physician         
assi/ants1 or nurse practition]s1 on--  
7#a7 me?ods to detect & diagnose r>e    
kidney disease1 includ+ ur9alysis &     
g5etic te/+2  7#b7 implem5t+ su*        
diagno/ic me?ods 9 _! practices2  7#c7  
e/abli%+ treatm5t protocols =           
individuals diagnos$ ) r>e kidney       
disease2 &  7#d7 implem5t+ a            
collaborative c>e model to coord9ate c>e
 ( pati5ts diagnos$ ) r>e kidney disease
 among heal? c>e provid]s4  7b7         
,priorities 9 mak+ aw>ds ,9 aw>d+ grants
 "u ?is section1 ! ,secret>y may give   
priority to qualifi$ applicants t--     

7#a7 h a record ( tra9+ prim>y c>e      
provid]s2  7#b7 e/abli% =mal            
relation%ips & submit jo9t applications 
) ,f$]ally qualifi$ heal? c5t]s1 rural  
heal? cl9ics1 or cl9ics locat$ 9        
und]s]v$ areas or t s]ve und]s]v$       
populations2 or  7#c7 tea* tra9ees !    
skills to provide int]pr(essional1      
integrat$ c>e ?r\gh collaboration among 
heal? pr(essionals1 includ+ speciali/s4 
7c7 ,au?orization ( appropriations ,!re 
is au?oriz$ to be appropriat$ to c>ry   
out ?is section #hjj1jjj = ea* ( fiscal 
ye>s #bjbc ?r\gh #bjbg4  4  #djb4 ,grant
 program = developm5t & implem5tation ( 
curricula = cont9u+ education on kidney 
disease ,"p ,c ( title ,,vii ( ! ,public
 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#bick et seq47 is am5d$-- 7#a7 9 ! "p   
head+1 by /rik+ & p$iatric d5ti/ry &    
ins]t+ p$iatric d5ti/ry1 & kidney       
disease2 &  7#b7 by ins]t+ aft] subp>t  
,,ii 7#db ,u4,s4,c4 #bicm7 ! foll[+3    
,,iii ,cont9u+ ,education 9 ,kidney     
,disease  #gdi;,c4 ,curricula = cont9u+ 

education on kidney disease  7a7 ,grants
 ,! ,secret>y may aw>d grants to        
eligible entities = ! developm5t &      
implem5tation ( curricula = provid+     
cont9u+ education & tra9+ to heal? c>e  
pr(essionals on id5tify+1 ref]r+1 &     
treat+ individuals ) kidney disease4    
7b7 ,eligible entities ,to be eligible  
to seek a grant "u ?is section1 an      
entity %all be a public or nonpr(it     
entity t-- 7#a7 provides cont9u+        
education or tra9+ to heal? c>e         
pr(essionals2 or  7#b7 applies = ! grant
 9 p>tn]%ip ) ano!r entity t provides   
su* education & tra9+4  7c7 ,pref]5ce ,9
 aw>d+ grants "u ?is section1 !         
,secret>y %all give pref]5ce to eligible
 entities propos+ to develop & implem5t 
curricula = provid+ cont9u+ education & 
tra9+ to--  7#a7 prim>y c>e provid]s2 or
  7#b7 heal? c>e pr(essionals :o are    
requir$1 z a condition ( ,/ate lic5sure1
 to p>ticipate 9 cont9u+ education or   
tra9+4  7d7 ,au?orization (             
appropriations ,to c>ry out ?is section1

 !re is au?oriz$ to be appropriat$      
#a1fjj1jjj = ea* ( fiscal ye>s #bjbc    
?r\gh #bjbg4  4  ,v ,cov]age & exp]im5ts
 to r$uce dialysis & transplant co/s    
#eja4 ,m$ical exp]tise 9 ph>macy &      
!rapeutic committees ,section           
#ahfj;,d-#d7;b77#c77;,a7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;b77#c77;,a77 is am5d$ by   
/rik+ clause 7ii7 & ins]t+ ! foll[+3    
7ii7 ,inclusion ( indep5d5t exp]ts ,su* 
committee %all include-- 7,i7 at lea/ "o
 practic+ physician & at lea/ "o        
practic+ ph>maci/1 ea* ( :om--  7aa7 is 
indep5d5t & free ( conflict ) respect to
 ! sponsor & plan2 &  7bb7 has exp]tise 
9 ! c>e ( eld]ly or disabl$ p]sons2 &   
7,,ii7 9 ! case ( a drug approv$ to     
treat a r>e disease or condition z def9$
 9 section #ebf ( ! ,f$]al ,food1 ,drug1
 & ,cosmetic ,act 7#ba ,u4,s4,c4        
#cfj;bb71 at lea/ two memb]s t meet !   
requirem5ts describ$ 9 items 7aa7 & 7bb7
 ( subclause 7,i7 & h exp]tise 9 ! field
 ( m$ic9e relat$ to t drug4  4  #ejb4   

,r$uc+ dialysis & transplant co/s relat$
 to r>e kidney disease ,section         
#ahha7;f7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acierr7f77 is am5d$ by  
add+ at ! end ! foll[+ new p>agraph3    
7#i7  7,a7 ,! ,secret>y %all conduct    
exp]im5ts to evaluate me?ods = treat+   
r>e kidney disease1 giv+ p>ticul>       
att5tion to treatm5ts t w\ld delay or   
elim9ate ! ne$ = dialysis & transplant4 
7,b7 ,! ,secret>y %all conduct a        
compreh5sive /udy ( me?ods to increase  
public aw>5ess ( r>e kidney disease1    
includ+ 9 communities ( color4  7,c7 ,! 
,secret>y %all submit to ,congress1 n   
lat] ?an #bd mon?s aft] ! date ( !      
enactm5t ( ! ,new ,era ( ,prev5t+       
,end-,/age ,kidney ,disease ,act1 a     
report on ! exp]im5ts & /udy conduct$ "u
 subp>agraphs 7,a7 & 7,b74 ,su* report  
%all include recomm5dations =           
legislative *anges t ! ,secret>y f9ds   
necess>y or desirable z a result ( su*  
exp]im5ts & /udy4  4