To provide coverage for kidney disease education services under the medicare program.

1. Adds SEC. __. MEDICARE COVERAGE OF KIDNEY DISEASE EDUCATION SERVICES on page 510, line 18

   Adds a sectionPrinted page

   Inserted: SEC. __. MEDICARE COVERAGE OF KIDNEY DISEASE EDUCATION SERVICES.

   Inserted: (a) Coverage of Kidney Disease Education Services.--

   Inserted: (1) In general.--Section 1861 of the Social Security Act (42 U.S.C.1395x) is amended--

   Inserted: (A) in subsection (s)(2)--

   Inserted: (i) in subparagraph (U), by striking "and" at the end;

   Inserted: (ii) in subparagraph (V)(iii), by adding "and" at the end; and

   Inserted: (iii) by adding at the end the following new subparagraph:

   Inserted: "(W) kidney disease education services (as defined in subsection (ww));"; and

   Inserted: (B) by adding at the end the following new subsection:

   Inserted: "Kidney Disease Education Services

   Inserted: "(ww)(1) The term 'kidney disease education services' means educational services that are--

   Inserted: "(A) furnished to an individual with kidney disease who, according to accepted clinical guidelines identified by the Secretary, will require dialysis or a kidney transplant;

   Show 28 more inserted paragraphsShow less

   Inserted: "(B) furnished, upon the referral of the physician managing the individual's kidney condition, by a qualified person (as defined in paragraph (2)); and

   Inserted: "(C) designed--

   Inserted: "(i) to provide comprehensive information regarding--

   Inserted: "(I) the management of comorbidities;

   Inserted: "(II) the prevention of uremic complications; and

   Inserted: "(III) each option for renal replacement therapy (including peritoneal dialysis, hemodialysis (including vascular access options), and transplantation); and

   Inserted: "(ii) to ensure that the individual has the opportunity to actively participate in the choice of therapy.

   Inserted: "(2) The term 'qualified person' means--

   Inserted: "(A) a physician (as described in subsection (r)(1));

   Inserted: "(B) an individual who--

   Inserted: "(i) is--

   Inserted: "(I) a registered nurse;

   Inserted: "(II) a registered dietitian or nutrition professional (as defined in subsection (vv)(2));

   Inserted: "(III) a clinical social worker (as defined in subsection (hh)(1));

   Inserted: "(IV) a physician assistant, nurse practitioner, or clinical nurse specialist (as those terms are defined in subsection (aa)(5)); or

   Inserted: "(V) a transplant coordinator; and

   Inserted: "(ii) meets such requirements related to experience and other qualifications that the Secretary finds necessary and appropriate for furnishing the services described in paragraph (1); or

   Inserted: "(C) a renal dialysis facility subject to the requirements of section 1881(b)(1) with personnel who--

   Inserted: "(i) provide the services described in paragraph (1); and

   Inserted: "(ii) meet the requirements of subparagraph (A) or (B).

   Inserted: "(3) The Secretary shall develop the requirements under paragraph (2)(B)(ii) after consulting with physicians, health educators, professional organizations, accrediting organizations, kidney patient organizations, dialysis facilities, transplant centers, network organizations described in section 1881(c)(2), and other knowledgeable persons.

   Inserted: "(4) In promulgating regulations to carry out this subsection, the Secretary shall ensure that such regulations ensure that each beneficiary who is entitled to kidney disease education services under this title receives such services in a timely manner that ensures that the beneficiary receives the maximum benefit of those services.

   Inserted: "(5) The Secretary shall monitor the implementation of this subsection to ensure that beneficiaries who are eligible for kidney disease education services receive such services in the manner described in paragraph (4).".

   Inserted: (2) Payment under physician fee schedule.--Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting ", (2)(W)", after "(2)(S)".

   Inserted: (3) Payment to renal dialysis facilities.--Section 1881(b) of such Act (42 U.S.C. 1395rr(b)), as amended by section 433(b)(5), is further amended by adding at the end the following new paragraph:

   Inserted: "(13) For purposes of paragraph (7), the single composite weighted formulas determined under such paragraph shall not take into account the amount of payment for kidney disease education services (as defined in section 1861(ww)). Instead, payment for such services shall be made to the renal dialysis facility on an assignment-related basis under section 1848.".

   Inserted: (4) Annual report to congress.--Not later than April 1, 2004, and annually thereafter, the Secretary of Health and Human Services shall submit to Congress a report on the number of medicare beneficiaries who are entitled to kidney disease education services (as defined in section 1861(ww) of the Social Security Act, as added by paragraph (1)) under title XVIII of such Act and who receive such services, together with such recommendations for legislative and administrative action as the Secretary determines to be appropriate to fulfill the legislative intent that resulted in the enactment of that subsection.

   Inserted: (b) Effective Date.--The amendments made by this section shall apply to services furnished on or after the date that is 6 months after the date of enactment of this Act.

   Original wording

   On page 510, after line 18, add the following:

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As printed