H.R. 3164House115th Congress (2017-2019)In Committee

To amend title XVIII of the Social Security Act to expand access to home dialysis therapy.

Introduced July 6, 2017

AI-Generated Summary

Updated April 15, 2026 at 5:00 PM UTC

The bill changes Medicare rules to make it easier for people with end‑stage renal disease (ESRD) to get dialysis at home. It lets patients receive certain monthly doctor visits by telehealth, expands where those telehealth visits can originate, removes facility fees when the home is used, clarifies the definition of telehealth, and orders a study on further expanding telehealth dialysis services.

Key Provisions

  • Patients on home dialysis can have their monthly ESRD‑related visits done via telehealth starting Jan. 1, 2019, but must have an in‑person visit each month for the first three months and at least once every three months thereafter.
  • Renal dialysis facilities and patients’ homes are added as approved telehealth originating sites for these monthly visits.
  • If the home is used as the originating site, Medicare will not pay a facility fee to any provider.
  • The definition of telehealth in Medicare law is updated to explicitly include services provided to ESRD patients after Jan. 1, 2019.
  • The Comptroller General must study the benefits and drawbacks of further expanding telehealth coverage for renal dialysis and report the findings to Congress within two years.

Legislative Activity

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2 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Health.

July 20, 2017

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HouseIntro Referral

Introduced in House

July 6, 2017

HouseIntro Referral

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.

July 6, 2017

HouseCommittee

Referred to the Subcommittee on Health.

July 20, 2017

Bill Text

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Introduced in HouseIssued July 6, 2017

I

115th CONGRESS

1st Session

H. R. 3164

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.

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).