[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5321 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 5321
To establish a pilot project to demonstrate the impact of payment for
more frequent hemodialysis treatment under the Medicare Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 9, 2006
Mr. Bass (for himself, Mr. McDermott, and Mr. Sam Johnson of Texas)
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 establish a pilot project to demonstrate the impact of payment for
more frequent hemodialysis treatment under the Medicare Program.
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 ``Access to Better Choice in Dialysis
Act of 2006''.
SEC. 2. MEDICARE PILOT PROJECT FOR PAYMENT FOR MORE FREQUENT
HEMODIALYSIS TREATMENT.
(a) In General.--Not later than 6 months after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
implement a 5-year pilot project to measure the impact of increasing
the payment amount otherwise provided under section 1881(b) of the
Social Security Act (42 U.S.C. 1395rr(b)), based upon the provision of
hemodialysis treatment more frequently than 3 times per week.
(b) Increased Payment Amount.--
(1) In general.--Under the pilot project, subject to
paragraph (2), the increase in payment amount shall be, in the
case of hemodialysis treatment provided--
(A) for a 4th session in a week, 70 percent of the
full composite rate;
(B) for a 5th session in a week, 40 percent of the
full composite rate;
(C) for a 6th session in a week, 30 percent of the
full composite rate;
(D) for a 7th session in a week, 20 percent of the
full composite rate; and
(E) for any subsequent session in a week, no
additional payment amount.
(2) Funding limitation.--The pilot program shall be
structured in a manner so that the total additional amounts
paid under the program for hemodialysis treatment during--
(A) its first year of operation does not exceed
$15,000,000;
(B) its second year of operation does not exceed
$30,000,000;
(C) its third year of operation does not exceed
$50,000,000;
(D) its fourth year of operation does not exceed
$75,000,000; and
(E) its fifth year of operation does not exceed
$90,000,000.
No expenditures shall be made for hemodialysis treatment under
the pilot program after its fifth year of operation.
(3) Funding from smi trust fund.--Funds from the Federal
Supplementary Medical Insurance Trust Fund under section 1841
of the Social Security Act (42 U.S.C. 1395t) shall be
available, in advance of appropriations, to meet obligations
arising from the pilot program under this section.
(c) Data Collection and Analysis.--
(1) Data collection.--The Secretary shall provide for the
collection of data to measure the clinical and financial impact
of higher frequency hemodialysis treatments, including its
impact on--
(A) health status and on the utilization of, and
expenditures for, other health care services, including
for separately-billable drugs, such as erythropoietin
(also known as Epogen), iron, and hospitalizations; and
(B) patients' working status, resulting in--
(i) a reduction in Social Security
Disability Insurance payments;
(ii) increased Federal and State income and
employment tax payments; and
(iii) a reduction in Medicare payments due
to increased coverage under employer group
health plans.
(2) Reports to congress.--The Secretary shall periodically
submit to Congress reports on the pilot program under this
section. The Secretary shall submit a final report to Congress
and to the Medicare Payment Advisory Commission no later than 6
months after the completion of the program. Such final report
shall include findings regarding the clinical and financial
impact of more frequent hemodialysis treatment.
(3) Medpac analysis.--The Medicare Payment Advisory
Commission shall evaluate the Secretary's findings in the final
report under paragraph (2) and shall submit to Congress, no
later than 6 months after the date of the Commission's receipt
of such final report, and shall include in the report its
analysis of the desirability of expanded medicare payment for
more frequent hemodialysis treatment.
(d) Definitions.--In this section:
(1) Full composite rate.--The term ``full composite rate''
means the rate determined under section 1881(b)(7) of the
Social Security Act (42 U.S.C. 1395rr(b)(7)).
(2) Hemodialysis treatment.--The term ``hemodialysis
treatment'' includes equivalent therapy requiring blood access,
but does not include treatment administered on an emergency or
acute basis.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
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