,,ii  #aaith ,,congress  #ast ,session  
,s4 #aagc  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #bg1    
#bjbe,mr4 ,cassidy 7for himself1 ,mr4   
,booker1 ,mr4 ,cramer1 and ,mr4         
,heinrich7 introduced the following     
bill2 which was read twice and referred 
to the ,committee on ,finance  ,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 protections under     
,medicare ,secondary ,payer provisions  
for individuals with end-stage renal    
disease by ensuring that private health 
plans do not discriminate against such  
individuals 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  
individuals with end-stage renal disease
 to the ,medicare program4  7#c7 ,to    
affirm the intent of ,congress 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 with end-stage  
renal disease and other individuals1 but
 does not change a plan's 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 
following3  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 following3 ,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 described in 
part #daa of title #db1 ,code of        

,federal ,regulations 7or any successor 
regulation744