[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1298 Introduced in House (IH)]
109th CONGRESS
1st Session
H. R. 1298
To amend title XVIII of the Social Security Act to improve the benefits
under the Medicare Program for beneficiaries with kidney disease, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 15, 2005
Mr. Camp 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 improve the benefits
under the Medicare Program for beneficiaries with kidney disease, 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Kidney Care
Quality and Improvement Act of 2005''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title.
TITLE I--RECOGNIZING AND IMPROVING QUALITY FOR PATIENTS
Sec. 101. Modification of physician surgical reimbursement for dialysis
access procedures to align incentives for
cost and quality.
Sec. 102. Demonstration project for outcomes-based ESRD reimbursement
system.
Sec. 103. Required training for patient care dialysis technicians.
TITLE II--ENSURING QUALITY THROUGH IMPROVEMENTS IN THE ESRD PAYMENT
SYSTEM
Sec. 201. Establishment of annual update framework for the medicare
ESRD composite rate.
Sec. 202. Extension of medicare secondary payer.
Sec. 203. GAO study and report on impact of G-codes.
TITLE III--IMPROVING QUALITY THROUGH PATIENT EDUCATION, ACCESS, AND
SAFETY INITIATIVES
Sec. 301. Support of public and patient education initiatives regarding
kidney disease.
Sec. 302. Medicare coverage of kidney disease patient education
services.
Sec. 303. Blood flow monitoring demonstration projects.
TITLE IV--IMPROVING QUALITY THROUGH IMPROVED COVERAGE
Sec. 401. Improving the home dialysis benefit.
Sec. 402. Institute of Medicine evaluation and report on home dialysis.
Sec. 403. Establishment of an End-Stage Renal Disease (ESRD) Advisory
committee.
TITLE I--RECOGNIZING AND IMPROVING QUALITY FOR PATIENTS
SEC. 101. MODIFICATION OF PHYSICIAN SURGICAL REIMBURSEMENT FOR DIALYSIS
ACCESS PROCEDURES TO ALIGN INCENTIVES FOR COST AND
QUALITY.
(a) Full Coverage of Dialysis Access Procedures in the Ambulatory
Surgical Center Setting.--The Secretary of Health and Human Services
shall include in the surgical procedures specified under section
1833(i)(1) of the Social Security Act (42 U.S.C. 1395l(i)(1)) the full
range of dialysis access procedures when provided to individuals with
end-stage renal disease who are entitled to benefits under part A and
enrolled under part B of title XVIII of the Social Security Act
pursuant to section 226A of that Act (42 U.S.C. 426). For purposes of
the preceding sentence, the full range of dialysis services includes
all reasonable and necessary intervention procedures for the creation,
repair, and maintenance of an individual's dialysis access, such as the
placement, insertion, and maintenance services related to fistulas,
synthetic grafts, tunnel catheters, and peritoneal dialysis catheters.
(b) Revision of RBRVS to Reflect the Difficulty of Vascular Access
Procedures.--The Secretary of Health and Human Services shall structure
the relative value units determined under section 1848(c)(2) of the
Social Security Act (42 U.S.C. 1395w-4(c)(2)) that are applicable with
respect to physicians' services for vascular access procedures to
encourage clinically appropriate placement of natural vascular access
for dialysis patients.
SEC. 102. DEMONSTRATION PROJECT FOR OUTCOMES-BASED ESRD REIMBURSEMENT
SYSTEM.
(a) Establishment.--Subject to the succeeding provisions of this
section, the Secretary of Health and Human Services (in this section
referred to as the ``Secretary'') shall establish demonstration
projects under which the Secretary shall evaluate methods that improve
the quality of care provided to medicare beneficiaries with end-stage
renal disease.
(b) Outcomes-Based ESRD Reimbursement System.--
(1) In general.--Under the demonstration projects, the
Secretary shall provide financial incentives to providers of
services and renal dialysis facilities that demonstrate
improved quality of care to such beneficiaries.
(2) Consideration of outcomes and case-mix.--In determining
whether a provider or facility has demonstrated an improved
quality of care under paragraph (1), the Secretary shall take
into account the outcomes of individuals receiving services
from the provider or facility and the case-mix of the provider
or facility, paying particular attention to improved patient
safety, better vaccination rates, and improved care for
diabetics.
(3) Incentives described.--The financial incentives
provided under paragraph (1) shall--
(A) reflect the interactions of payments under
parts A and B of title XVIII of the Social Security
Act; and
(B) recognize improvements based on high quality
outcomes during previous periods as well as recent
changes in performance to reward long-term
improvements.
(c) Duration.--The Secretary shall conduct the demonstration
project under this section for a period that is not longer than 5 years
that begins on January 1, 2007.
(d) Evaluation and Report.--
(1) Evaluation.--The Secretary shall conduct an evaluation
of the demonstration projects conducted under this section.
(2) Report.--Not later than 6 months after the date on
which the demonstration projects are completed, the Secretary
shall submit to Congress a report on the evaluation conducted
under paragraph (1) together with recommendations for such
legislation and administrative action as the Secretary
determines appropriate.
(e) Waiver Authority.--The Secretary shall waive compliance with
the requirements of title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) to such extent and for such period as the Secretary
determines is necessary to conduct the demonstration projects.
(f) Authorization of Appropriations.--
(1) In general.--Payments for the costs of carrying out the
demonstration project under this section shall be made from the
Federal Supplementary Medical Insurance Trust Fund under
section 1841 of such Act (42 U.S.C. 1395t).
(2) Amount.--There are authorized to be appropriated from
such Trust Fund such sums as may be necessary to carry out this
section.
SEC. 103. REQUIRED TRAINING FOR PATIENT CARE DIALYSIS TECHNICIANS.
(a) In General.--Section 1881 of the Social Security Act (42 U.S.C.
1395rr) is amended by adding the following:
``(h)(1) Except as provided in paragraph (3), beginning January 1,
2007, a provider of services or a renal dialysis facility may not use
any individual as a patient care dialysis technician for more than 4
months unless the individual--
``(A) has completed a training program in the care and
treatment of an individual with chronic kidney failure who is
undergoing dialysis treatment;
``(B) has been certified by a nationally recognized
certification entity for dialysis technicians; and
``(C) is competent to provide dialysis-related services.
``(2) Beginning January 1, 2008, a provider of services or a renal
dialysis facility may not use on a temporary, per diem, leased, or on
any basis other than as a permanent employee, any individual as a
patient care dialysis technician unless the individual meets the
requirements described in subparagraphs (A), (B), and (C) of paragraph
(1).
``(3) A provider of services or a renal dialysis facility may
permit an individual enrolled in a training program described in
paragraph (1)(A) to serve as a patient care dialysis technician while
they are so enrolled.
``(4) For purposes of paragraph (1), if, since the most recent
completion by an individual of a training program described in
paragraph (1)(A), there has been a period of 24 consecutive months
during which the individual has not performed dialysis-related services
for monetary compensation, such individual shall be required to
complete a new training program or become re-certified as described in
paragraph (1)(B).
``(5) A provider of services or a renal dialysis facility shall
provide such regular performance review and regular in-service
education as assures that individuals serving as patient care dialysis
technicians for the provider or facility are competent to perform
dialysis-related services.''.
TITLE II--ENSURING QUALITY THROUGH IMPROVEMENTS IN THE ESRD PAYMENT
SYSTEM
SEC. 201. ESTABLISHMENT OF ANNUAL UPDATE FRAMEWORK FOR THE MEDICARE
ESRD COMPOSITE RATE.
(a) In General.--Section 1881(b)(12)(F) of the Social Security Act
(42 U.S.C. 1395rr(b)(12)(F)) is amended to read as follows:
``(F) Beginning with 2006, the Secretary shall annually increase
the basic case-mix adjusted payment amounts established under this
paragraph--
``(i) with respect to the component of the basic case-mix
adjusted system described in clause (ii) of subparagraph (B),
by--
``(I) applying the estimated growth in expenditures
for drugs and biologicals (including erythropoietin)
that are separately billable to such component; and
``(II) converting the amount determined in
subclause (I) to an increase applicable to the basic
case-mix adjusted payment amounts established under
such subparagraph; and
``(ii) with respect to the composite rate component of the
basic case-mix adjusted system described in subparagraph
(B)(i), for dialysis services furnished--
``(I) during 2006, by 2.5 percent above such
payment amounts for such services furnished on December
31, 2005;
``(II) during 2007 through 2014, by an amount equal
to 1 percent of the ESRD market basket percentage
increase (as defined in paragraph (14)(A) and including
any additional factors that may increase costs
described in paragraph (14)(B)) above such composite
rate payment amounts for such services furnished on
December 31 of the previous year; and
``(III) during 2015 and subsequent years, by the
ESRD market basket percentage increase (as defined in
paragraph (14)(A) and including any additional factors
that may increase costs described in paragraph (14)(B))
above such composite rate payment amounts for such
services furnished on December 31 of the previous
year.''.
(b) ESRD Market Basket Percentage Increase Defined.--Section
1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended by
adding at the end the following new paragraph:
``(14)(A) For purposes of this title, the term `ESRD market basket
percentage increase' means, with respect to a calendar year, the
percentage (estimated by the Secretary before the beginning of such
year) by which--
``(i) the cost of the mix of goods and services included in
the provision of dialysis services (including the costs
described in subparagraph (D)) that is determined based on an
index of appropriately weighted indicators of changes in wages
and prices which are representative of the mix of goods and
services included in such dialysis services for the calendar
year; exceeds
``(ii) the cost of such mix of goods and services for the
preceding calendar year.
``(B) In addition to determining the percentage update under
subparagraph (A), the Secretary shall also take into account any change
in the costs of furnishing the mix of goods and services described in
such subparagraph resulting from--
``(i) the adoption of scientific and technological
innovations used to provide dialysis services;
``(ii) changes in the manner or method of delivering
dialysis services;
``(iii) productivity improvements in the provision of
dialysis services; and
``(iv) any other relevant factor.
``(C) The Secretary shall annually review and update the items and
services included in the mix of goods and services used to determine
the percentage under subparagraph (A).
``(D) The costs described in this subparagraph include--
``(i) labor costs, including direct patient care costs and
administrative labor costs, vacation and holiday pay, payroll
taxes, and employee benefits;
``(ii) other direct costs, including drugs, supplies, and
laboratory fees;
``(iii) overhead costs, including medical director fees,
temporary services, general and administrative costs, interest
expenses, and bad debt;
``(iv) capital costs, including rent, real estate taxes,
depreciation, utilities, repairs, and maintenance; and
``(v) such other allowable costs as the Secretary may
specify.''.
SEC. 202. EXTENSION OF MEDICARE SECONDARY PAYER.
Section 1862(b)(1)(C) of the Social Security Act (42 U.S.C.
1395y(b)(1)(C)) is amended--
(1) in the last sentence, by inserting ``, and before
January 1, 2006'' after ``prior to such date)''; and
(2) by adding at the end the following new sentence:
``Effective for items and services furnished on or after
January 1, 2006 (with respect to periods beginning on or after
the date that is 30 months prior to such date), clauses (i) and
(ii) shall be applied by substituting `33-month' for `12-month'
each place it appears in the first sentence.''.
SEC. 203. GAO STUDY AND REPORT ON IMPACT OF G-CODES.
(a) Study.--The Comptroller General of the United States shall
conduct a study on the impact of the temporary codes for nephrologists'
services applicable under the fee schedule for physicians' services
under section 1848 of the Social Security Act (42 U.S.C. 1395w-4)
(commonly known as ``G-codes'').
(b) Report.--Not later than the date that is 6 months after the
date of enactment of this Act, the Comptroller General shall submit to
Congress a report on the study conducted under subsection (a) together
with recommendations for such legislation and administrative action as
the Comptroller General determines appropriate.
TITLE III--IMPROVING QUALITY THROUGH PATIENT EDUCATION, ACCESS, AND
SAFETY INITIATIVES
SEC. 301. SUPPORT OF PUBLIC AND PATIENT EDUCATION INITIATIVES REGARDING
KIDNEY DISEASE.
(a) Chronic Kidney Disease Demonstration Projects.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') shall
establish demonstration projects to--
(A) increase public awareness about the factors
that lead to chronic kidney disease, how to prevent it,
how to treat it, and how to avoid kidney failure; and
(B) enhance surveillance systems and expand
research to better assess the prevalence and incidence
of chronic kidney disease.
(2) Scope and duration.--
(A) Scope.--The Secretary shall select at least 3
States in which to conduct demonstration projects under
this subsection. In selecting the States under this
subparagraph, the Secretary shall take into account the
size of the population of medicare beneficiaries with
end-stage renal disease and ensure the participation of
individuals who reside in rural and urban areas.
(B) Duration.--The demonstration projects under
this subsection shall be conducted for a period that is
not longer than 5 years that begins on January 1, 2007.
(3) Evaluation and report.--
(A) Evaluation.--The Secretary shall conduct an
evaluation of the demonstration projects conducted
under this subsection.
(B) Report.--Not later than 6 months after the date
on which the demonstration projects under this
subsection are completed, the Secretary shall submit to
Congress a report on the evaluation conducted under
subparagraph (A) together with recommendations for such
legislation and administrative action as the Secretary
determines appropriate.
(4) Authorization of appropriations.--There are authorized
to be appropriated to carry out this subsection $2,000,000 for
each of fiscal years 2007 through 2011.
(b) ESRD Self-Management Demonstration Projects.--
(1) In general.--The Secretary shall establish
demonstration projects to enable individuals with end-stage
renal disease to develop self-management skills.
(2) Scope and duration.--
(A) Scope.--The Secretary shall select at least 3
States in which to conduct demonstration projects under
this subsection. In selecting the States under this
subparagraph, the Secretary shall take into account the
size of the population of medicare beneficiaries with
end-stage renal disease and ensure the participation of
individuals who reside in rural and urban areas.
(B) Duration.--The demonstration projects under
this section shall be conducted for a period that is
not longer than 5 years that begins on January 1, 2007.
(3) Evaluation and report.--
(A) Evaluation.--The Secretary shall conduct an
evaluation of the demonstration projects conducted
under this subsection.
(B) Report.--Not later than 6 months after the date
on which the demonstration projects under this
subsection are completed, the Secretary shall submit to
Congress a report on the evaluation conducted under
subparagraph (A) together with recommendations for such
legislation and administrative action as the Secretary
determines appropriate.
(4) Authorization of appropriations.--There are authorized
to be appropriated to carry out this subsection $2,000,000 for
each of fiscal years 2007 through 2011.
SEC. 302. MEDICARE COVERAGE OF KIDNEY DISEASE PATIENT EDUCATION
SERVICES.
(a) Coverage of Kidney Disease Education Services.--
(1) Coverage.--Section 1861(s)(2) of the Social Security
Act (42 U.S.C. 1395x(s)(2)) is amended--
(A) in subparagraph (Y), by striking ``and'' after
the semicolon at the end;
(B) in subparagraph (Z), by adding ``and'' after
the semicolon at the end; and
(C) by adding at the end the following new
subparagraph:
``(AA) kidney disease education services (as defined in
subsection (bbb));''.
(2) Services described.--Section 1861 of the Social
Security Act (42 U.S.C. 1395x) is amended by adding at the end
the following new subsection:
``Kidney Disease Education Services
``(bbb)(1) The term `kidney disease education services' means
educational services that are--
``(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;
``(B) furnished, upon the referral of the physician
managing the individual's kidney condition, by a qualified
person (as defined in paragraph (2)); and
``(C) designed--
``(i) to provide comprehensive information
regarding--
``(I) the management of comorbidities;
``(II) the prevention of uremic
complications; and
``(III) each option for renal replacement
therapy (including home and in-center as well
as vascular access options and
transplantation); and
``(ii) to ensure that the individual has the
opportunity to actively participate in the choice of
therapy.
``(2) The term `qualified person' means--
``(A) a physician (as described in subsection (r)(1));
``(B) an individual who--
``(i) is--
``(I) a registered nurse;
``(II) a registered dietitian or nutrition
professional (as defined in subsection
(vv)(2));
``(III) a clinical social worker (as
defined in subsection (hh)(1));
``(IV) a physician assistant, nurse
practitioner, or clinical nurse specialist (as
those terms are defined in subsection (aa)(5));
or
``(V) a transplant coordinator; and
``(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
``(C) a renal dialysis facility subject to the requirements
of section 1881(b)(1) with personnel who--
``(i) provide the services described in paragraph
(1); and
``(ii) meet the requirements of subparagraph (A) or
(B).
``(3) The Secretary shall develop the requirements under paragraphs
(1)(C)(i) and (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.
``(4) In promulgating regulations to carry out this subsection, the
Secretary shall ensure that each beneficiary who is entitled to kidney
disease education services under this title receives such services in a
timely manner to maximize the benefit of those services.
``(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).
``(6) No individual shall be eligible to be provided more than 6
sessions of kidney disease education services under this title.''.
(3) Payment under the physician fee schedule.--Section
1848(j)(3) of the Social Security Act (42 U.S.C. 1395w-4(j)(3))
is amended by inserting ``(2)(AA),'' after ``(2)(W),''.
(4) Payment to renal dialysis facilities.--Section 1881(b)
of the Social Security Act (42 U.S.C. 1395rr(b)), as amended by
section 201(b), is amended by adding at the end the following
new paragraph:
``(15) For purposes of paragraph (12), 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(bbb)). Instead, payment for such services shall
be made to the renal dialysis facility on an assignment-related basis
under section 1848.''.
(5) Limitation on number of sessions.--Section 1862(a)(1)
of the Social Security Act (42 U.S.C. 1395y(a)(1)) is amended--
(A) by striking ``and'' at the end of subparagraph
(L);
(B) by striking the semicolon at the end of
subparagraph (M) and inserting ``, and''; and
(C) by adding at the end the following new
subparagraph:
``(N) in the case of kidney disease education services (as
defined in section 1861(bbb)), which are performed in excess of
the number of sessions covered under such section;''.
(6) Annual report to congress.--Not later than April 1,
2007, and annually thereafter, the Secretary of Health and
Human Services (in this section referred to as the
``Secretary'') 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(bbb) of the
Social Security Act, as added by paragraph (2)) 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.
(b) Effective Date.--The amendments made by this section shall
apply to services furnished on and after January 1, 2007.
SEC. 303. BLOOD FLOW MONITORING DEMONSTRATION PROJECTS.
(a) Establishment.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall establish
demonstration projects to evaluate how blood flow monitoring affects
the quality and cost of care for medicare beneficiaries with end-stage
renal disease.
(b) Duration.--The demonstration projects under this section shall
be conducted for a period of not longer than 5 years that begins on
January 1, 2007.
(c) Evaluation and Report.--
(1) Evaluation.--The Secretary shall conduct an evaluation
of the demonstration projects conducted under this section.
(2) Report.--Not later than 6 months after the date on
which the demonstration projects under this section are
completed, the Secretary shall submit to Congress a report on
the evaluation conducted under paragraph (1) together with
recommendations for such legislation and administrative action
as the Secretary determines appropriate.
(d) Waiver Authority.--The Secretary shall waive compliance with
the requirements of title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) to such extent and for such period as the Secretary
determines is necessary to conduct the demonstration projects.
(e) Authorization of Appropriations.--
(1) In general.--Payments for the costs of carrying out the
demonstration project under this section shall be made from the
Federal Supplementary Medical Insurance Trust Fund under
section 1841 of such Act (42 U.S.C. 1395t).
(2) Amount.--There are authorized to be appropriated from
such Trust Fund $1,000,000 for each of fiscal years 2007
through 2011 to carry out this section.
TITLE IV--IMPROVING QUALITY THROUGH IMPROVED COVERAGE
SEC. 401. IMPROVING THE HOME DIALYSIS BENEFIT.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall provide
appropriate incentives to improve the home dialysis benefit for
individuals on behalf of whom payment may be made under section 1881 of
the Social Security Act (42 U.S.C. 1395rr).
(b) Considerations.--In developing the incentives under subsection
(a), the Secretary shall consider revising the fee schedule for
physicians' services under section 1848 of the Social Security Act (42
U.S.C. 1395w-4) so that the amount paid for services related to end-
stage renal disease furnished to home dialysis patients is equal to the
amount paid for services related to end-stage renal disease furnished
to other patients with 4 or more face-to-face physician visits per
month.
SEC. 402. INSTITUTE OF MEDICINE EVALUATION AND REPORT ON HOME DIALYSIS.
(a) Evaluation.--
(1) In general.--Not later than the date that is 2 months
after the date of enactment of this Act, the Secretary of
Health and Human Services (in this section referred to as the
``Secretary'') shall enter into an arrangement under which the
Institute of Medicine of the National Academy of Sciences (in
this section referred to as the ``Institute'') shall conduct an
evaluation of the barriers that exist to increasing the number
of individuals with end-stage renal disease who elect to
receive home dialysis services under the medicare program under
title XVIII of the Social Security Act (42 U.S.C. 1395 et
seq.).
(2) Specific matters evaluated.--In conducting the
evaluation under paragraph (1), the Institute shall--
(A) compare current medicare home dialysis costs
and payments with current in-center and hospital
dialysis costs and payments;
(B) catalogue and evaluate the incentives and
disincentives in the current reimbursement system that
influence whether patients receive home dialysis
services;
(C) evaluate patient education services and how
such services impact the treatment choices made by
patients; and
(D) consider such other matters as the Institute
determines appropriate.
(3) Scope of review.--The Institute shall consider a
variety of perspectives, including the perspectives of
physicians, other health care professionals, hospitals,
dialysis facilities, health plans, purchasers, and patients.
(b) Report.--Not later than the date that is 18 months after the
date of enactment of this Act, the Institute shall submit to the
Secretary and appropriate committees of Congress a report on the
evaluation conducted under subsection (a)(1) describing the findings of
such evaluation and recommendations for implementing incentives to
encourage patients to elect to receive home dialysis services under the
medicare program.
(c) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary for the purposes of
conducting the evaluation and preparing the report required by this
section.
SEC. 403. END-STAGE RENAL DISEASE (ESRD) ADVISORY COMMITTEE.
(a) Establishment.--Pursuant to section 222 of the Public Health
Service Act (42 U.S.C. 217a), the Secretary of Health and Human
Services shall establish within 1 year of the date of enactment of this
Act an independent, multidisciplinary, nonpartisan End-Stage Renal
Disease Advisory Committee (in this section referred to as the
``Committee'').
(b) Membership.--The Committee shall consist of such members as the
Secretary may appoint who shall serve for such term as the Secretary
may specify. In appointing members of the Committee, the Secretary
shall consult with the dialysis community and shall include individuals
drawn from diverse backgrounds, such as medicine, nursing, health care
policy, the dialysis patient community, the dialysis provider
community, and health economics.
(c) Purpose of the Committee.--
(1) Duties.--The Committee shall provide a forum for expert
discussion and deliberation and the formulation of advice and
recommendations to the Secretary about medicare coverage for
End-Stage Renal Disease patients, as described under section
1881 of the Social Security Act (42 U.S.C. 1395rr).
(2) Report.--The Committee shall provide the Secretary with
periodic reports that summarize the Committee's activities and
its recommendations for such legislation and administrative
action as it considers appropriate.
(d) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out the purposes of
this section.
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