,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #baii  ,,in ,,the ,,house ,,of  
,,representatives  ,march #ah1 #bjbe,mr4
 ,kelly of ,pennsylvania 7for himself1  
,ms4 ,clarke of ,new ,york1 ,mr4 ,dunn  
of ,florida1 ,mr4 ,davis of ,illinois1  
,mr4 ,joyce of ,pennsylvania1 and ,mr4  
,ruiz7 introduced the following bill2   
which was referred to the ,committee on 
,ways and ,means1 and in addition to the
 ,committee on ,energy and ,commerce1   
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 clarify and preserve  
the breadth of the protections under the
 ,medicare ,secondary ,payer ,act4  #a4 
,short title ,this ,act may be cited as 
the ,restore ,protections for ,dialysis 
,patients ,act4  #b4 ,purposes ,the     
purposes of this ,act are the following3
 7#a7 ,to restore the ,,mspa's          

protections for ,,esrd patients by      
ensuring that private health plans do   
not discriminate against such patients  
or adversely classify dialysis as       
compared to other covered medical       
services4  7#b7 ,to prohibit health     
insurance plans from shifting primary   
responsibility for covering the cost of 
health care services needed by patients 
with ,,esrd to the ,medicare program4   
7#c7 ,to affirm ,congress' intent by    
clarifying that singling out dialysis   
services for disfavored treatment       
through coverage limitations as compared
 to other covered health services       
constitutes inappropriate               
differentiations between the benefits   
provided to individuals having ,,esrd   
and other individuals1 but does not     
change a plan's current ability to limit
 which renal dialysis providers it      
includes in the provider network it     
elects to offer its enrollees4  #c4     
,clarification and preservation of      
prohibition under the ,medicare program 

,section #ahfb7;b77#a77;,c7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#aciey7b77#a77;,c77 is amended-- 7#a7 by
 striking clause 7ii7 and inserting the 
following new clause3  7ii7 may not on  
any basis 7including the diagnosis of   
end stage renal disease or the need for 
renal dialysis7 or in any manner-- 7,i7 
differentiate 7or have the effect of    
differentiating7 in the benefits it     
provides between individuals having end 
stage renal disease and other           
individuals covered by such plan2 or    
7,,ii7 apply a limitation on benefits   
7including on network composition7 under
 the plan that will disparately affect  
individuals having end stage renal      
disease2  2 and  7#b7 by adding at the  
end of the matter following clause 7ii7 
the following new sentences3 ,nothing in
 this subsection shall be construed as  
requiring a group health plan to include
 a particular renal dialysis provider or
 a particular number of renal dialysis  
providers as part of the provider       

network the group health plan elects to 
offer its enrollees4 ,the ,secretary    
shall enforce this subparagraph         
consistent with the nonconformance      
determination requirements set forth in 
part #daa of title #db1 ,code of        
,federal ,regulations44