Sec. 7504. Home dialysis and increasing end-stage renal disease treatment modalities in minority communities action plan
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Section 1881(b)(14) of the Social Security Act ( 42 U.S.C. 1395rr(b)(14) ) is amended by adding at the end the following new subparagraph: For services furnished on or after the date which is 1 year after the date of the enactment of this subparagraph which are staff-assisted home dialysis (as defined in clause (iv)(III)), the Secretary shall increase the single payment that would otherwise apply under this paragraph for renal dialysis services furnished to new and respite individuals in accordance with the payment system established under clause
(iii)by qualified providers. Subject to subclause (II), staff-assisted home dialysis may only be furnished during— with respect to an individual described in subclause (iv)(I)(aa), one 90-day period which may be renewed up to two 30-day periods; and with respect to an individual described in subclause (iv)(I)(bb) and notwithstanding whether such an individual receives any respite care under part A, any 30-day period. Notwithstanding the limits described in subclause (I), staff-assisted home dialysis may be furnished for as long as the Secretary determines appropriate to an individual who— is blind; has a cognitive or neurological impairment (including a stroke, Alzheimer’s, dementia, amyotrophic lateral sclerosis, or any other impairment determined by the Secretary); or has any other illness or injury that reduces mobility (including cerebral palsy, spinal cord injuries, or any other illness or injury determined by the Secretary). The Secretary shall establish an add-on to the single payment under this paragraph through regulations to determine the amounts payable to qualified providers for staff-assisted home dialysis. In establishing such system add-on payment, the Secretary may consider— the costs of furnishing staff-assisted home dialysis; consultations with dialysis providers, dialysis patients, private payers, and Medicare Advantage plans; payment amounts for similar items and services under parts A and B; and payment amounts established by Medicare Advantage plans under part C, group health plans, and health insurance coverage offered by health insurance issuers. In this subparagraph: The term new and respite individual means an individual described in subsection
(a)who is— initiating either peritoneal or home hemodialysis; receiving home dialysis and is unable to self-dialyze due to illness, injury, caregiver issues, or other temporary circumstances; or returning to home dialysis after a period of hospitalization. The term qualified provider means a trained professional (as determined by the Secretary, including nurses and certified patient technicians) who furnishes renal dialysis services and— meets requirements (as determined by the Secretary) that ensures competency in patient care and modality usage; and provides in-person assistance to a patient for an appropriate number of dialysis sessions (as determined by the Secretary) at least 75 percent of staff-assisted home dialysis sessions during a period described in clause (ii)(I). The term staff-assisted home dialysis means home dialysis using trained professionals to assist individuals who have been determined to have end stage renal disease, and the frequency of such home dialysis is determined by such professionals in coordination with the patient and his or her care partner, and outlined in a patient plan of care. The term care partner means anyone who is designated by the patient who assists the individual with the furnishing of home dialysis. The term patient plan of care has the meaning given such term in section 494.90 of title 42, Code of Federal Regulations. . Section 1881(b)(5) of the Social Security Act ( 42 U.S.C. 1395rr(b)(5) ) is amended— in subparagraph (C), by striking at the end and ; in subparagraph (D), by striking the period at the end and inserting a semicolon; and by adding at the end the following: educate patients of the opportunity to receive staff-assisted home dialysis (as defined in paragraph (14)(J)(iv)(III)) during the period beginning 30 days after the first day such facility furnishes renal dialysis services to an individual and ending 60 days after such day; and provide for nurses, certified patient technicians, social workers and or other professionals to train patients and their care partners in skills and procedures needed to perform home dialysis (as defined in paragraph (14)(J)(iv)(III)) treatment— regularly and independently; through telehealth services or through group training (as described in the interpretive guidance relating to tag number V590 of Advance Copy–End Stage Renal Disease
(ESRD)Program Interpretive Guidance Version 1.1 (published on October 3, 2008)) in accordance with the Federal regulations (concerning the privacy of individually identifiable health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996; and in the home or residence of a patient, in a dialysis facility, or in the place in which the patient intends to receive staff-assisted home dialysis. . Not later than 2 years after the date of the enactment of this Act, the Director of the National Institute of Diabetes and Digestive and Kidney Diseases, in consultation with the Director of the Centers for Disease Control and Prevention, shall develop a national action plan to increase the number of home dialyzers and choice in dialysis treatment modality in the United States with participation from patients, caregivers, health professionals, patient advocacy organizations, researchers, providers, public health professionals, and other stakeholders in minority communities. At a minimum, such plan shall include recommendations for— public health officials for the purpose of implementation of the national plan; biomedical, health services, and public health research on home dialysis and modalities in minority communities; and inclusion of dialysis location and modality in the health data collections of all Federal agencies. There are authorized to be appropriated to carry out this section $1,000,000 for fiscal year 2023, $1,000,000 for fiscal year 2024, $1,000,000 for fiscal year 2025, $1,000,000 for fiscal year 2026, and $1,000,000 for fiscal year 2027.
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Sec. 7504
Home dialysis and increasing end-stage renal disease treatment modalities in minority communities action plan
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