Medicare Home Hemodialysis Improvement Act of 1990

Medicare Home Hemodialysis Improvement Act of 1990 - Amends title XVIII (Medicare) of the Social Security Act to cover the services of a home dialysis aide provided by a renal dialysis facility to persons who are nonambulatory, whose health would be endangered by travel to and from a dialysis facility, who have no other potential caregiver who is available or able to provide home hemodialysis, and who are eligible for ambulance transportation to and from a renal dialysis facility. Sets forth home dialysis payment amounts, but prohibits payment in excess of the Medicare payment which would otherwise have been made for such ambulance services.

Directs the Secretary of Health and Human Services to conduct a study and report to the Congress on the costs and effectiveness of various home dialysis services available to end stage renal disease patients.

 
HR 4951 IH
101st CONGRESS
2d Session
 H. R. 4951
To amend title XVIII of the Social Security Act to provide for payment under
the medicare program for the services of home dialysis aides who provide
medical assistance during hemodialysis treatment at the homes of end stage
renal disease patients, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
May 24, 1990
Mr. WALGREN introduced the following bill; which was referred jointly to
the Committees on Energy and Commerce and Ways and Means
A BILL
To amend title XVIII of the Social Security Act to provide for payment under
the medicare program for the services of home dialysis aides who provide
medical assistance during hemodialysis treatment at the homes of end stage
renal disease patients, and for other purposes.
  Be it enacted by the Senate and House of Representatives of the United
  States of America in Congress assembled,
SECTION 1. SHORT TITLE.
  This Act may be cited as the `Medicare Home Hemodialysis Improvement Act
  of 1990'.
SEC. 2. MEDICARE PAYMENT FOR STAFF ASSISTANT FOR HOME DIALYSIS PATIENTS.
  (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 (1)--
  (A) by striking `and (B)' and inserting `(B)', and
  (B) by striking the period at the end and inserting the following: `,
  and (C) in accordance with paragraph (8), payments to or on behalf of such
  individuals for services of a home dialysis aide providing medical assistance
  during hemodialysis treatment at the individual's home, including technical
  assistance with the operation of a hemodialysis machine, administration of
  medications, and other assistance with the individual's care and treatment.';
  (2) by redesignating paragraphs (8), (9), (10), and (11) as paragraphs (9),
  (10), (11), and (12); and
  (3) by inserting after paragraph (7) the following new paragraph:
  `(8)(A) The Secretary shall make a payment to a provider of services or
  a renal dialysis facility for services of a home dialysis aide providing
  medical assistance to a patient during hemodialysis treatment at the
  patient's home if the patient's attending physician certifies that--
  `(i) the home dialysis aide is qualified to provide such assistance under
  criteria developed by the Secretary;
  `(ii) the patient is confined to a bed or wheelchair;
  `(iii) the patient's health would be endangered by travel to and from a
  provider of services or renal dialysis facility;
  `(iv) no family member or other individual is available or able to provide
  such assistance to the patient; and
  `(v) the patient meets the eligibility requirements under this Act for
  coverage of ambulance service provided to the patient.
  `(B) Subject to subparagraph (C), the amount of a payment made under this
  paragraph for services of a home dialysis aide shall be equal to--
  `(i) an amount not less than $50 (adjusted for regional variations in the
  cost of providing such services) in the case of services furnished by a
  home dialysis aide who is not a registered nurse; and
  `(ii) an amount not less than $80 (adjusted for regional variations in
  the cost of providing such services) in the case of services furnished by
  a home dialysis aide who is a registered nurse.
  `(C) The amount of a payment made under this paragraph for services furnished
  to a home dialysis patient may not exceed the amount of payment that would
  be made under this Act for ambulance service provided to the patient.'.
  (b) EFFECTIVE DATE- The amendments made by subsection (a) shall apply to
  services of a home dialysis aide furnished on or after January 1, 1991.
SEC. 3. STUDY OF HOME DIALYSIS SERVICES.
  (a) STUDY- The Secretary of Health and Human Services (hereinafter referred
  to as the `Secretary') shall conduct a study of the costs and effectiveness
  of various home dialysis services available to end stage renal disease
  patients, including services for which payment is made under the medicare
  program as a result of the enactment of the Medicare Home Hemodialysis
  Improvement Act of 1990.
  (b) REPORT- Not later than July 1, 1993, the Secretary shall submit a
  report to Congress on the study conducted under subsection (a), and shall
  include in such report recommendations regarding appropriate criteria and
  cost-control mechanisms for coverage of various home dialysis services
  under the medicare program.