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H.R. 1005 (ih) To provide permanent funding for the payment in lieu of taxes program, and for other purposes. [Introduced in House] ...

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  1st Session
                                H. R. 1004

To amend title XVIII of the Social Security Act to provide for payment 
 under the Medicare Program for more frequent hemodialysis treatments.



                           February 27, 2003

    Mr. McDermott (for himself, Ms. Dunn, Mr. Lewis of Georgia, Mr. 
 Cummings, Mr. Dicks, Mr. Rangel, Mr. McNulty, Mr. Goode, Mr. Hastings 
 of Washington, Mr. Inslee, Mr. Kirk, and Mrs. Christensen) introduced 
 the following bill; which was referred to the Committee on Energy and 
  Commerce, and in addition to the Committee on Ways and Means, for a 
 period to be subsequently determined by the Speaker, 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 provide for payment 
 under the Medicare Program for more frequent hemodialysis treatments.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,


    This Act may be cited as the ``Kidney Patient Daily Dialysis 
Quality Act of 2003''.


    (a) In General.--Section 1881(b) of the Social Security Act (42 
U.S.C. 1395rr(b)) is amended--
            (1) in the first sentence of paragraph (7), by inserting 
        before the period the following: ``, including payment for more 
        frequent hemodialysis furnished to qualified individuals under 
        paragraph (12)''; and
            (2) by adding at the end the following new paragraph:
    ``(12)(A)(i) Not later than the date that is 1 year after the date 
of enactment of this paragraph, the Secretary shall cause to have 
published in the Federal Register final regulations for equivalent per 
treatment prospective payment rates for more frequent hemodialysis 
furnished at home and furnished in a facility (commonly known as 
composite `Method I' rates and `Method II Cap' payment rates), and 
prospective payment rates for in-facility training for more frequent 
    ``(ii) For the year beginning more than 12 months after the date 
described in clause (i), and for each subsequent year, the Secretary 
shall provide for an appropriate update to the per treatment 
prospective payment rates developed under clause (i).
    ``(B) In developing per treatment prospective payment rates under 
subparagraph (A), the Secretary shall consider--
            ``(i) actual reasonable costs of operating more frequent 
        hemodialysis programs; and
            ``(ii) data from the Health Care Financing Administration 
        on actual expenditures under this title for more frequent 
        hemodialysis patients, compared to--
                    ``(I) data on expenditures for the same patients 
                before those patients underwent more frequent 
                hemodialysis, and
                    ``(II) data on expenditures for patients undergoing 
                hemodialysis treatment 3 times per week with similar 
                clinical and demographic characteristics.
    ``(C) Not later than 1 year after the date of enactment of this 
paragraph, the Secretary shall develop, in consultation with the renal 
community, a standard of care and quality standards for more frequent 
hemodialysis. The Secretary shall periodically review and update as 
necessary such standards.
    ``(D) The Secretary shall collect data with respect to--
            ``(i) documented savings in expenditures under this title 
        by reason of more frequent hemodialysis that are attributable 
        to reduced medications, hospitalizations, outpatient services, 
        and such other factors as the Secretary determines appropriate; 
            ``(ii) the improved quality of care and improved outcomes 
        more frequent hemodialysis may bring to patients.
    ``(E) In this paragraph:
            ``(i) The term `more frequent hemodialysis' means 
        hemodialysis treatment sessions, or equivalent therapy 
        requiring blood access, performed at least 5 times per week.
            ``(ii) The term `qualified individual' means an individual 
        who, in the clinical judgment of the physician of the 
        individual, is likely to achieve better clinical outcomes, 
        quality of life outcomes, or both from more frequent 
    (b) Conforming Amendments.--(1) Section 1881(b)(8) of the Social 
Security Act (42 U.S.C. 1395rr(b)(8)) is amended by inserting ``and 
more frequent hemodialysis supplies and equipment'' after ``home 
dialysis supplies and equipment''.
    (2) Section 1881(b)(9) of such Act (42 U.S.C. 1395rr(b)(9)) is 
amended by inserting ``and more frequent hemodialysis support 
services'' after ``self-care home dialysis support services''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date of the enactment of this Act and shall apply with 
respect to items and services furnished on or after the date that is 1 
year after such date of enactment.

Pages: 1

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