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Title II — Promoting Access to Chronic Kidney Disease Treatments

H.R. 4814 · 113th Congress · Jun 9, 2014 · Lineage

II Promoting Access to Chronic Kidney Disease Treatments

Sec. 201 Increasing access to Medicare kidney disease education benefit

(a)
In general— Section 1861(ggg) of the Social Security Act (42 U.S.C. 1395x(ggg)) is amended—
(1)
in paragraph (1)—
(A)
in subparagraph (A), by inserting “ or stage V” after “stage IV”;
(B)
in subparagraph (B), by inserting “or of a physician assistant, nurse practitioner, or clinical nurse specialist (as defined in section 1861(aa)(5)) assisting in the treatment of the individual’s kidney condition” after “kidney condition”; and
(2)
in paragraph (2)—
(A)
by striking subparagraph (B); and
(B)
in subparagraph (A)—
(i)
by striking “(A)” after “(2)”;
(ii)
by striking “and” at the end of clause (i);
(iii)
by striking the period at the end of clause (ii) and inserting “; and”;
(iv)
by redesignating clauses (i) and (ii) as subparagraphs (A) and (B), respectively; and
(v)
by adding at the end the following:

“(C) a renal dialysis facility subject to the requirements of section 1881(b)(1) with personnel who—

“(i) provide the services described in paragraph (1); and

“(ii) is a physician (as defined in subsection (r)(1)) or a physician assistant, nurse practitioner, or clinical nurse specialist (as defined in subsection (aa)(5)).”

(b)
Payment to renal dialysis facilities— Section 1881(b) of such Act (42 U.S.C. 1395rr(b)) is amended by adding at the end the following new paragraph:

“(15) For purposes of paragraph (14), the single payment for renal dialysis services under such paragraph shall not take into account the amount of payment for kidney disease education services (as defined in section 1861(ggg)). Instead, payment for such services shall be made to the renal dialysis facility on an assignment-related basis under section 1848.”

(c)
Effective date— The amendments made by this section apply to kidney disease education services furnished on or after January 1, 2015.

Sec. 202 Improving access to chronic kidney disease treatment in underserved rural and urban areas

(a)
Definition of primary care services— Section 331(a)(3)(D) of the Public Health Service Act (42 U.S.C. 254d(a)(3)(D)) is amended by inserting “and includes renal dialysis services” before the period at the end.
(b)
National Health Service Corps Scholarship Program— Section 338A(a)(2) of the Public Health Service Act (42 U.S.C. 254l(a)(2)) is amended by inserting “, including nephrologists and non-physician practitioners providing renal dialysis services” before the period at the end.
(c)
National Health Service Corps Loan Repayment Program— Section 338B(a)(2) of the Public Health Service Act (42 U.S.C. 254l–1(a)(2)) is amended by inserting “, including nephrologists and non-physician practitioners providing renal dialysis services” before the period at the end.

Sec. 203 Promoting access to home dialysis treatments

(a)
Monthly capitation payments— Notwithstanding any other provision of law, with respect to dialysis services furnished on or after January 1, 2015, the Secretary of Health and Human Services shall apply with respect to visits by a physician provided within a month to an end stage renal disease patient receiving dialysis services at home, the alternative Medicare billing procedures, as described in the final rule promulgated by the Secretary in the Federal Register on November 7, 2003 (68 Fed. Reg. 63216), for physicians managing patients on dialysis, with respect to visits by such a physician provided within a month to an end stage renal disease patient who is hospitalized during the month.
(b)
Telehealth— Section 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the following new subclause:

“(IX) A renal dialysis facility (as defined in section 1881).”

Sec. 204 Expand access for patients with acute kidney injury

Section 1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended—
(1)
in paragraph (1), by inserting “or acute kidney injury” after “individuals who have been determined to have end stage renal disease”;
(2)
in paragraph (2)(A), by inserting “or acute kidney injury” after “end stage renal disease”;
(3)
in paragraph (2)(B), by inserting “or acute kidney injury” after “end stage renal disease”;
(4)
in paragraph (3), in the matter preceding subparagraph (A), by inserting “or acute kidney injury” after “end stage renal disease”;
(5)
in paragraph (11)(A), by inserting “or acute kidney injury” after “end stage renal disease”;
(6)
in paragraph (11)(B), by inserting “or acute kidney injury” after “end stage renal disease”;
(7)
in paragraph (14)(B)—
(A)
in clause (ii), by inserting “or acute kidney injury” after “end stage renal disease”;
(B)
in clause (iii), by inserting “or acute kidney injury” after “end stage renal disease”; and
(C)
in clause (iv), by inserting “or acute kidney injury” after “end stage renal disease”; and
(8)
in paragraph (14)(H)(i), by inserting “or acute kidney injury” after “end stage renal disease”.