,,ii  #aai? ,,congress  #a/ ,session    
,s4 #aagc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #bg1 #bjbe,mr4    
,cassidy 7= himself1 ,mr4 ,book]1 ,mr4  
,cram]1 & ,mr4 ,he9ri*7 introduc$ !     
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,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 protections  
"u ,m$ic>e ,second>y ,pay] provisions = 
individuals ) end-/age r5al disease by  
ensur+ t private heal? plans d n        
discrim9ate aga9/ su* individuals or    
adv]sely classify dialysis z comp>$ 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 individuals ) 
end-/age r5al disease to ! ,m$ic>e      

program4  7#c7 ,to affirm ! int5t (     
,congress 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 )        
end-/age r5al disease & o!r individuals1
 b does n *ange a plan's 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[+3    
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[+3 ,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    
describ$ 9 "p #daa ( title #db1 ,code ( 
,f$]al ,regulations 7or any successor   
regulation744