This bill amends title XVIII (Medicare) of the Social Security Act to allow a Medicare beneficiary who has end-stage renal disease (ESRD) and is receiving home dialysis to receive monthly ESRD-related visits via telehealth, provided that the beneficiary also receives face-to-face visits periodically. Specified facility fees and geographic requirements shall not apply with respect to the provision of such services via telehealth.
The Government Accountability Office must study and report to Congress on the further expansion of Medicare coverage of renal dialysis services furnished via telehealth.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3164 Introduced in House (IH)]
<DOC>
115th CONGRESS
1st Session
H. R. 3164
To amend title XVIII of the Social Security Act to expand access to
home dialysis therapy.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 6, 2017
Mrs. Black (for herself, Ms. DelBene, Mr. Thompson of California, and
Mr. Meehan) 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 expand access to
home dialysis therapy.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. EXPANDING ACCESS TO HOME DIALYSIS THERAPY.
(a) Allowing Use of Telehealth for Monthly End Stage Renal Disease-
Related Visits.--
(1) In general.--Paragraph (3) of section 1881(b) of the
Social Security Act (42 U.S.C. 1395rr(b)) is amended--
(A) by redesignating subparagraphs (A) and (B) as
clauses (i) and (ii), respectively;
(B) in clause (ii), as redesignated by subparagraph
(A)--
(i) by inserting ``subject to subparagraph
(B),'' before ``on a comprehensive''; and
(ii) by striking ``under this
subparagraph'' and inserting ``under this
clause'';
(C) by striking ``With respect to'' and inserting
``(A) With respect to''; and
(D) by adding at the end the following new
subparagraph:
``(B)(i) Subject to clause (ii), an individual who is determined to
have end stage renal disease and who is receiving home dialysis may
choose to receive monthly end stage renal disease-related visits,
furnished on or after January 1, 2019, via telehealth.
``(ii) Clause (i) shall apply to an individual only if the
individual receives a face-to-face visit, without the use of
telehealth--
``(I) in the case of the initial three months of home
dialysis of such individual, at least monthly; and
``(II) after such initial three months, at least once every
three consecutive months.''.
(2) Conforming amendment.--Paragraph (1) of such section is
amended by striking ``paragraph (3)(A)'' and inserting
``paragraph (3)(A)(i)''.
(b) Expanding Originating Sites for Telehealth To Include Renal
Dialysis Facilities and the Home for Purposes of Monthly End Stage
Renal Disease-Related Visits.--
(1) In general.--Section 1834(m) of the Social Security Act
(42 U.S.C. 1395m(m)) is amended--
(A) in paragraph (4)(C)(ii), by adding at the end
the following new subclauses:
``(IX) A renal dialysis facility,
but only for purposes of section
1881(b)(3)(B).
``(X) The home of an individual,
but only for purposes of section
1881(b)(3)(B).''; and
(B) by adding at the end the following new
paragraph:
``(5) Treatment of home dialysis monthly esrd-related
visit.--The geographic requirements described in paragraph
(4)(C)(i) shall not apply with respect to telehealth services
furnished on or after January 1, 2019, for purposes of section
1881(b)(3)(B), at an originating site described in subclause
(VI), (IX), or (X) of paragraph (4)(C)(ii)).''.
(2) No facility fee if originating site for home dialysis
therapy is the home.--Section 1834(m)(2)(B) of the Social
Security (42 U.S.C. 1395m(m)(2)(B)) is amended--
(A) by redesignating clauses (i) and (ii) as
subclauses (I) and (II), respectively, and by indenting
each of such subclauses 2 ems to the right;
(B) in subclause (II), as redesignated by
subparagraph (A), by striking ``clause (i) or this
clause'' and inserting ``subclause (I) or this
subclause'';
(C) by striking ``site.--With respect to'' and
inserting ``site.--
``(i) In general.--Subject to clause (ii),
with respect to''; and
(D) by adding at the end the following new clause:
``(ii) No facility fee if originating site
for home dialysis therapy is the home.--No
facility fee shall be paid under this
subparagraph to an originating site described
in subclause (X) of paragraph (4)(C)(ii).''.
(c) Clarification Regarding Telehealth Provided to Beneficiaries.--
Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended--
(1) in subparagraph (H), by striking ``; or'' and inserting
a semicolon;
(2) in subparagraph (I), by striking the period at the end
and inserting ``; or''; and
(3) by adding at the end the following new subparagraph:
``(J) the provision of telehealth on or after
January 1, 2019, to individuals with end stage renal
disease under title XVIII by a health care provider for
the purpose of furnishing of telehealth.''.
(d) Study and Report on Further Expansion.--
(1) Study.--The Comptroller General of the United States
shall conduct a study to examine the benefits and drawbacks of
expanding the coverage under the Medicare program under title
XVIII of the Social Security Act of renal dialysis services as
telehealth services, pursuant to the amendments made by this
section, to include coverage of renal dialysis services
furnished via telehealth and other store-and-forward
technologies.
(2) Report.--Not later than two years after the date of the
enactment of this Act, the Comptroller General shall submit to
Congress a report on the results of the study conducted under
paragraph (1).
<all>
Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
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