,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #baii  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #ah1 #bjbe,mr4   
,kelly ( ,p5nsylvania 7= himself1 ,ms4  
,cl>ke ( ,new ,york1 ,mr4 ,dunn (       
,florida1 ,mr4 ,davis ( ,ill9ois1 ,mr4  
,joyce ( ,p5nsylvania1 & ,mr4 ,ruiz7    
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means1 & 9    
addition to ! ,committee on ,en]gy &    
,comm]ce1 = 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 cl>ify &      
pres]ve ! bread? ( ! protections "u !   
,m$ic>e ,second>y ,pay] ,act4  #a4 ,%ort
 title ,?is ,act may be cit$ z ! ,re/ore
 ,protections = ,dialysis ,pati5ts ,act4
  #b4 ,purposes ,! purposes ( ?is ,act  
are ! foll[+3 7#a7 ,to re/ore ! ,,mspa's
 protections = ,,esrd pati5ts by ensur+ 
t private heal? plans d n discrim9ate   
aga9/ su* pati5ts or adv]sely classify  

dialysis z comp>$ to o!r cov]$ m$ical   
s]vices4  7#b7 ,to prohibit heal?       
insurance plans f %ift+ prim>y          
responsibility = cov]+ ! co/ ( heal? c>e
 s]vices ne$$ by pati5ts ) ,,esrd to !  
,m$ic>e program4  7#c7 ,to affirm       
,congress' int5t by cl>ify+ t s+l+ out  
dialysis s]vices = disfavor$ treatm5t   
?r\gh cov]age limitations z comp>$ to   
o!r cov]$ heal? s]vices con/itutes      
inappropriate diff]5tiations betwe5 !   
b5efits provid$ to individuals hav+     
,,esrd & o!r individuals1 b does n *ange
 a plan's curr5t ability to limit :i*   
r5al dialysis provid]s x includes 9 !   
provid] network x elects to (f] its     
enrollees4  #c4 ,cl>ification &         
pres]vation ( prohibition "u ! ,m$ic>e  
program ,section #ahfb7;b77#a77;,c7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciey7b77#a77;,c77 is am5d$-- 7#a7 by  
/rik+ clause 7ii7 & ins]t+ ! foll[+ new 
clause3  7ii7 may n on any basis        
7includ+ ! diagnosis ( end /age r5al    
disease or ! ne$ = r5al dialysis7 or 9  

any mann]-- 7,i7 diff]5tiate 7or h !    
effect ( diff]5tiat+7 9 ! b5efits x     
provides betwe5 individuals hav+ end    
/age r5al disease & o!r individuals     
cov]$ by su* plan2 or  7,,ii7 apply a   
limitation on b5efits 7includ+ on       
network composition7 "u ! plan t w      
disp>ately affect individuals hav+ end  
/age r5al disease2  2 &  7#b7 by add+ at
 ! end ( ! matt] foll[+ clause 7ii7 !   
foll[+ new s5t5ces3 ,no?+ 9 ?is         
subsection %all be con/ru$ z requir+ a  
gr\p heal? plan to include a p>ticul>   
r5al dialysis provid] or a p>ticul>     
numb] ( r5al dialysis provid]s z "p ( ! 
provid] network ! gr\p heal? plan elects
 to (f] its enrollees4 ,! ,secret>y %all
 en=ce ?is subp>agraph consi/5t ) !     
noncon=mance det]m9ation requirem5ts set
 =? 9 "p #daa ( title #db1 ,code (      
,f$]al ,regulations44