,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #ieji  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #bi1 #bjbf,ms4  
,del,bene 7= h]self & ,mr4 ,joyce (     
,p5nsylvania7 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 &    
title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act ) respect to ! cov]age ( kidney   
disease education s]vices "u ,m$ic>e &  
private heal? insurance4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,kidney 
,disease ,education ,access ,expansion  
,act ( #bjbf4  #b4 ,exp&+ cov]age (     
kidney disease education s]vices "u     
,m$ic>e  7a7 ,kidney disease education  
s]vices & kidney disease scre5+  7#a7   
,provid]s ( kidney disease education    
s]vices ,section #ahfa7;ggg77#b77;,a7 ( 

! ,social ,security ,act 7#db ,u4,s4,c4 
#aciex7ggg77#b77;,a77 is am5d$ to read z
 foll[s3  7,a7 ,! t]m qualifi$ p]son    
means-- 7i7 a physician 7z def9$ 9      
section #ahfa7r77#a77 or a physician    
assi/ant1 regi/]$ nurse1 nurse          
practition]1 or cl9ical nurse speciali/ 
7z def9$ 9 section #ahfa7;aa77#e771 :o  
furni%es s]vices = :i* paym5t may be    
made "u ! fee s*$ule e/abli%$ "u section
 #ahdh2  7ii7 a provid] ( s]vices locat$
 9 a rural area 7z def9$ 9 section      
#ahhf7;d77#b77;,d772  7iii7 a cl9ical   
social work] 7z def9$ 9 section         
#ahfa7;hh77#a772  7iv7 a regi/]$        
dietitian or nutrition pr(essional 7z   
def9$ 9 section #ahfa7vv772 or  7v7 any 
o!r individual1 su* z a community heal? 
work]1 :o is tra9$ 79 a mann] det]m9$   
appropriate by ! ,secret>y7 to assi/ 9 !
 deliv]y ( kidney disease education     
s]vices "u ! direction ( a qualifi$     
entity describ$ 9 any ( clauses 7i71    
7iii71 or 7iv74  4  7#b7 ,eligibility = 
kidney disease education s]vices        

,section #ahfa7;ggg77#a77;,a7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7ggg77#a77;,a77 is am5d$ by /rik+ 
an individual ) /age ,,iv *ronic kidney 
disease :o1 accord+ to accept$ cl9ical  
guidel9es id5tifi$ by ! ,secret>y1 w    
require dialysis or a kidney transplant 
& ins]t+ an individual ) hyp]t5sion1    
diabetes1 any /age ( *ronic kidney      
disease1 or o!r risk factors = kidney   
disease progression or kidney failure z 
det]m9$ by ! qualifi$ entity4  7#c7     
,scope ( kidney disease education       
s]vices  7,a7 ,p]mitt+ gr\p s]vices &   
pres5ce ( c>egiv]s ,section             
#ahfa7;ggg77#a77;,a7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#aciex7ggg77#a77;,a771 z am5d$ by       
p>agraph 7#b71 is fur!r am5d$--  7i7 by 
ins]t+ 9 an individual or gr\p sett+    
aft] furni%$2 &  7ii7 by ins]t+ 7&1 at !
 option ( ! individual1 9 ! pres5ce (   
su* individual's c>egiv]7 be=e !        
semicolon at ! end4  7,b7 ,exp&+ scope (
 s]vices ,section                       

#ahfa7;ggg77#a77;,c77i7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#aciex7ggg77#a77;,c77i77 is am5d$-- 7i7 
9 subclause 7,,ii71 by /rik+ & at ! end2
 &  7ii7 by add+ at ! end ! foll[+ new  
subclauses3  7,,iv7 !rapeutic options to
 sl[ kidney function decl9e 9           
individuals ) kidney disease :o are at  
risk ( kidney disease progression or    
kidney failure2  7,v7 c>egiv] tra9+ &   
support = new transplant recipi5ts2     
7,,vi7 basic transition assi/ance =     
individuals :o h receiv$ a kidney       
transplant1 includ+ education on g5]al  
po/-transplant self-c>e1 coord9ation (  
foll[-up c>e1 & ref]ral to a transplant 
nephrologi/ or o!r appropriate          
transplant speciali/ = ongo+ cl9ical    
managem5t ( transplant-relat$ m$ical    
ne$s2 &  7,,vii7 su* o!r topics z !     
,secret>y deems appropriate = pati5t    
safety & optimal transplant outcomes2  4
  7b7 ,initial prev5tive physical       
exam9ation ,section #ahfa7ww77#b7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   

#aciex7ww77#b77 is am5d$--  7#a7 9      
subp>agraph 7,n71 by adju/+ ! m>g9 ( su*
 subp>agraph #b ems to ! left2  7#b7 by 
r$esignat+ subp>agraph 7,o7 z           
subp>agraph 7,p72 &  7#c7 by ins]t+ aft]
 subp>agraph 7,n7 ! foll[+ new          
subp>agraph3  7,o7 ,scre5+ = *ronic     
kidney disease1 kidney failure1 & r>e   
kidney diseases 7z det]m9$ by !         
,secret>y7 & kidney disease education   
s]vices z describ$ 9 subsection 7ggg74  
4  7c7 ,annual wellness visit ,section  
#ahfa7;hhh77#b7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #aciex7hhh77#b77 is 
am5d$-- 7#a7 9 subp>agraphs 7,g7 & 7,h71
 by adju/+ ! m>g9 ( ea* su* subp>agraph 
#a em to ! left2  7#b7 by r$esignat+    
subp>agraph 7,i7 z subp>agraph 7,j72 &  
7#c7 by ins]t+ aft] subp>agraph 7,h7 !  
foll[+ new subp>agraph3  7,i7 ,scre5+ = 
*ronic kidney disease & kidney failure  
?r\gh r\t9e metabolic & ur9>y assessm5ts
 consi/5t ) /&>d cl9ical practice1 z    
det]m9$ by ! ,secret>y1 & ?r\gh su*     
additional scre5+ te/s or assessm5ts    

7:i* may include new & em]g+ diagno/ic  
tools7 z ! ,secret>y det]m9es           
appropriate1 & a ref]ral1 z appropriate1
 = kidney disease education s]vices z   
describ$ 9 subsection 7ggg74  4  7d7    
,numb] ( kidney disease education       
sessions ,section #ahfa7;ggg77#d7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7ggg77#d77 is am5d$ by /rik+ m ?an
 #f sessions ( kidney disease education 
s]vices "u ?is title & ins]t+ a numb] ( 
sessions ( kidney disease education     
s]vices "u ?is title t exce$s ! numb] ( 
su* sessions t ! ,secret>y1 9           
consultation ) individuals describ$ 9   
p>agraph 7#a77;,a71 c>egiv]s1 & qualifi$
 p]sons 7z def9$ 9 p>agraph 7#b771      
det]m9es is appropriate4  7e7 ,furni%+  
kidney disease education s]vices ?r\gh  
teleheal? ,section #ahcd7m77#d77;,f7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciem7#d77;,f77 is am5d$ by ins]t+ 1   
kidney disease education s]vices 7z     
def9$ 9 section #ahfa7;ggg77 be=e 1 &   
any additional s]vice4  7f7 ,paym5t     

rules ,section #ahcc7;a77#a7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciel7a77#a77 is am5d$--  7#a7 9       
subp>agraph 7,,gg71 by /rik+ & at ! end2
 &  7#b7 by ins]t+ 1 & 7,,ii7 ) respect 
to kidney disease education s]vices 7z  
def9$ 9 section #ahfa7;ggg77#a771 !     
am\nt paid %all be #ajj p]c5t ( ! less] 
( ! actual *>ge = ! s]vices or ! am\nt  
det]m9$ "u ! paym5t basis det]m9$ "u    
section #ahdh be=e ! semicolon at ! end4
  7g7 ,effective date ,! am5dm5ts made  
by ?is section %all apply ) respect to  
s]vices furni%$ on or aft] ,janu>y #a1  
#bjbg4  #c4 ,kidney disease education   
effectiv5ess work+ gr\p2 kidney disease 
education assessm5t  7a7 ,kidney disease
 education effectiv5ess work+ gr\p  7#a7
 ,9 g5]al ,n lat] ?an #ahj days aft] !  
date ( enactm5t ( ! ,kidney ,disease    
,education ,access ,expansion ,act (    
#bjbf1 ! ,secret>y ( ,heal? & ,human    
,s]vices 79 ?is section ref]r$ to z !   
,secret>y7 %all conv5e a work+ gr\p to  
develop & evaluate me?odologies =       

measur+ pati5t b5efit & educational     
effectiv5ess f kidney disease education 
s]vices "u section #ahfa7;ggg7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7ggg774  7#b7 ,composition ,!     
work+ gr\p %all consi/ (-- 7,a7 qualifi$
 entities t furni% kidney disease       
education s]vices2  7,b7 individuals )  
kidney disease & _! c>egiv]s2  7,c7     
heal? c>e te*nology speciali/s2  7,d7   
le>n+ & educational assessm5t           
speciali/s2 &  7,e7 repres5tatives f !  
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices4    
7#c7 ,duties ,! work+ gr\p %all-- 7,a7  
develop evid5ce-bas$ me?odologies =     
assess+ pati5t compreh5sion1 behavior   
*ange1 & cl9ical outcomes result+ f     
kidney disease education s]vices2  7,b7 
acc\nt = div]se le>n+ /yles & ! impact (
 kidney disease on cognitive function 9 
develop+ assessm5t tools2  7,c7 recomm5d
 /&>diz$ metrics = evaluat+ !           
effectiv5ess ( diff]5t educational      
approa*es & deliv]y me?ods2 &  7,d7     
provide recomm5dations = quality        

improvem5t /rategies bas$ on            
pati5t-c5t]$ outcomes4  7#d7 ,report ,n 
lat] ?an #ah mon?s aft] ! work+ gr\p is 
conv5$ "u p>agraph 7#a71 ! work+ gr\p   
%all submit a report to ! ,secret>y &   
,congress & make publicly available its 
recomm5dations = measur+ & improv+      
kidney disease education effectiv5ess4  
7b7 ,kidney disease education assessm5t 
7#a7 ,e/abli%m5t ( assessm5t framework  
,n lat] ?an #b ye>s aft] ! ,secret>y    
receives ! report ( ! work+ gr\p "u     
subsection 7a77#d71 ! ,secret>y %all1   
tak+ into acc\nt ! recomm5dations       
includ$ 9 su* report1 e/abli% a         
compreh5sive assessm5t framework to     
evaluate ! success & effectiv5ess (     
kidney disease education s]vices provid$
 "u section #ahfa7;ggg7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#aciex7ggg774  7#b7 ,scope ( au?ority ,9
 e/abli%+ & implem5t+ ! assessm5t       
framework "u p>agraph 7#a71 ! ,secret>y 
%all--  7,a7 det]m9e ! specific         
me?odologies1 tools1 & metrics to be us$

 9 assess+ pati5t outcomes1 educational 
effectiv5ess1 & program success2  7,b7  
e/abli% ! frequ5cy & tim+ ( assessm5ts1 
:i* may v>y bas$ on qualifi$ entity     
type1 pati5t population s]v$1 or o!r    
relevant factors2  7,c7 specify data    
collection requirem5ts & proc$ures =    
qualifi$ entities provid+ kidney disease
 education s]vices2  7,d7 modify        
assessm5t crit]ia & proc$ures z ne$$    
bas$ on evid5ce1 outcomes data1 or      
*anges 9 cl9ical practice guidel9es2    
7,e7 e/abli% report+ requirem5ts =      
assessm5t results & _! use 9 program    
improvem5t2 &  7,f7 coord9ate ) relevant
 ,f$]al ag5cies1 pr(essional            
organizations1 & /akehold]s to ensure   
assessm5t activities align ) broad]     
heal? c>e quality initiatives4  7#c7    
,implem5tation flexibility ,! ,secret>y 
may implem5t ! assessm5t framework "u   
p>agraph 7#a7 ?r\gh guidance1           
regulations1 pilot programs1 or o!r     
me*anisms z deem$ appropriate1 & may    
phase implem5tation across diff]5t      

qualifi$ entity types or geographic     
regions z necess>y4  7#d7 ,cont9u\s     
improvem5t ,! ,secret>y %all use        
assessm5t results to id5tify            
opportunities = program improvem5t1 be/ 
practices1 & evid5ce-bas$ modifications 
to kidney disease education s]vices1 &  
may adju/ paym5t policies1 cov]age      
crit]ia1 or quality measures bas$ on    
assessm5t f9d+s4  #d4 ,includ+ kidney   
disease education s]vices z a prev5tive 
s]vice "u private heal? insurance  7a7  
,9 g5]al ,section #bgac7;a7 ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg--#ac7;a77 is am5d$-- 7#a7 9     
p>agraph 7#b71 by /rik+ & at ! end2     
7#b7 9 p>agraph 7#c71 by /rik+ ! p]iod  
at ! end & ins]t+ a semicolon2  7#c7 9  
p>agraph 7#d71 by /rik+ ! p]iod at ! end
 & ins]t+ a semicolon2  7#d7 9 p>agraph 
7#e71 by /rik+ ! p]iod at ! end & ins]t+
 2 &2 &  7#e7 by add+ at ! end ! foll[+ 
new p>agraph3  7#f7 kidney disease      
education s]vices1 z def9$ 9 section    
#ahfa7;ggg7 ( ! ,social ,security ,act4 

4  7b7 ,effective date ,! am5dm5ts made 
by ?is section %all apply ) respect to  
plan ye>s beg9n+ on or aft] ,janu>y #a1 
#bjbg4