Section 1 Short title
This Act may be cited as the “Improving Home Dialysis Act of 2026”.
Improving Home Dialysis Act of 2026
A BILL
To amend title XVIII of the Social Security Act to include certain additional services as self-care home dialysis support services under the Medicare program.
Sec. 2 Including certain additional services as self-care home dialysis support services under the Medicare program
in subparagraph (C), by striking “and” at the end;
by redesignating subparagraph (D) as subparagraph (F);
by inserting after subparagraph (C) the following new subparagraphs:
“(D) beginning January 1, 2028, staff-assisted home dialysis respite care furnished to a patient in the place of residence used as such patient’s home (other than a skilled nursing facility or a nursing facility (as defined in section 1919(a)));
“(E) beginning January 1, 2028, renal mental health services furnished to a patient in the place of residence used as such patient’s home (other than a skilled nursing facility or a nursing facility (as defined in section 1919(a))); and”
by adding at the end the following flush matter:
Payment adjustments for certain self-care home dialysis support services—
in subparagraph (D)—
in clause (iii), by striking “and” at the end;
by redesignating clause (iv) as clause (vi); and
by inserting after clause (iii) the following new clauses:
“(iv) shall include a payment adjustment for staff-assisted home dialysis respite care (as described in paragraph (9)(D)) in accordance with subparagraph (J);
“(v) shall include a payment adjustment for renal mental health services (as described in paragraph (9)(E)) in accordance with subparagraph (K); and”
by adding at the end the following new subparagraphs:
“(J)
“(i) For purposes of subparagraph (D)(iv), subject to clause (ii), a payment adjustment shall be made for each session of staff-assisted home dialysis respite care (as described in paragraph (9)(D)) furnished during a year equal to the amount of the add-on per treatment adjustment for home and self-dialysis training furnished in 2025 (or, in the case of such care that is not furnished in a rural area (as defined for purposes of such subparagraph), 75 percent of such amount).
“(ii) In no case may a payment adjustment under subparagraph (D)(iv) be made for staff-assisted home dialysis respite care furnished to an individual—
“(I) for more than 20 sessions in a calendar year; or
“(II) on a day when such individual was not dialyzing at home.
“(iii) Any payment adjustment under subparagraph (D)(iv) for staff-assisted home dialysis respite care shall not be made in a budget neutral manner.
“(K)
“(i) For purposes of subparagraph (D)(v), subject to clause (ii), a payment adjustment shall be made for each session of renal mental health services (as described in paragraph (9)(E)) furnished during a year equal to 50 percent (or 25 percent, in the case of such services that are not furnished in a rural area (as defined for purposes of subparagraph (D))) of the amount of the add-on per treatment adjustment for home and self-dialysis training furnished in 2025.
“(ii) In no case may a payment adjustment under subparagraph (D)(v) be made for renal mental health services furnished to an individual—
“(I) for more than 4 sessions occurring during the 60-day period beginning on the first day that the individual initiates home dialysis; or
“(II) on a day when such individual was not dialyzing at home.
“(iii) Any payment adjustment under subparagraph (D)(v) for renal mental health services shall not be made in a budget neutral manner.”
Conforming amendment— Section 1834(r)(1) of the Social Security Act (42 U.S.C. 1395m(r)(1)) is amended by striking “subparagraph (D)(iv)(II)” and inserting “subparagraph (D)(vi)(II)”.