3.0.0 2163 2019-11-15T21:52:17Z 2019-11-15T21:52:17Z Senate S S 2012-03-06 112 ssfi00 Finance Committee Senate Standing Referred to 2012-03-06T22:14:57Z Kidney Disease Equitable Access, Prevention, and Research Act of 2012 112 6011 HR 2012-07-02 Referred to the Subcommittee on Health. Related bill CRS 2012-03-06 ssfi00 Finance Committee Senate Read twice and referred to the Committee on Finance. IntroReferral 2012-03-06 Sponsor introductory remarks on measure. (CR S1425) IntroReferral B00100 9 Library of Congress 2012-03-06 Introduced in Senate IntroReferral 10000 9 Library of Congress C000705 Sen. Conrad, Kent [D-ND] KENT CONRAD D ND N Health Congressional oversight Digestive and metabolic diseases Government studies and investigations Health care costs and insurance Health care quality Health facilities and institutions Health promotion and preventive care Home and outpatient care Licensing and registrations Medical research Medicare Minority health Transportation costs Health 00 2012-03-06 Introduced in Senate 2012-09-06T18:10:39Z Kidney Disease Equitable Access, Prevention, and Research Act of 2012 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS), in specified circumstances, to accept the results of a state licensure survey for purposes of determining federal certification of the compliance of a renal dialysis facility (RDF) with the conditions of Medicare participation.

Allows the Secretary to assess and collect reasonable fees for the initial Medicare survey from an RDF.

Revises Medicare requirements for group health plans to extend from 12 to 42 months after an individual becomes eligible for Medicare part A (Hospital Insurance Benefits for the Aged and Disabled) benefits the period during which a group health plan is a primary payer (and Medicare the secondary payer) for ESRD patients.

Requires such a plan to: (1) provide adequate, advanced, written notice to patients regarding changes to dialysis service benefits, new restrictions on out-of-network access, or reductions in rates paid for out-of-network benefits; (2) allow patients to continue using their existing provider or facility for dialysis services for at least 24 months after a plan or issuer notice of any change; (3) hold patients harmless from a provider network change if the change requires unreasonable drive time or disrupts the physician-patient relationship; (4) ensure that out-of-pocket payments for such services apply to the Medicare part C (Medicare+Choice Program) out-of-pocket maximums and are treated as non-routine for copayment purposes; and (5) meet minimum network adequacy standards.

Prohibits such a plan from: (1) restricting the duration or number of dialysis sessions for patients to less than the number for which payment may be made; (2) requiring assignment of benefits for such services; or (3) denying or limiting coverage for patients for such services if premiums, copayments, or other payments are made by third parties on their behalf.

Directs the Secretary to study: (1) the social, behavioral, and biological factors leading to kidney disease; and (2) efforts to slow the progression of kidney disease in minority populations that are disproportionately affected by it.

Directs the Secretary to report to Congress on the research gaps with respect to the development of quality metrics and care management metrics for ESRD patients.

Directs the Comptroller General to evaluate the transportation barriers facing dialysis patients that result in less than 100% compliance with their plan of care under the Medicare program.

Includes as a person qualified to furnish kidney disease education services an RDF with a physician or a physician assistant, nurse practitioner, or clinical nurse specialist.

Declares that the mandatory single payment to an RDF or other provider of renal dialysis services shall not take into account the amount of payment for kidney disease education services.

Revises the definition of “kidney disease education services” to specify education services furnished to individuals: (1) with stage V (as well as those with stage IV) chronic kidney disease, and (2) who are not receiving dialysis services.]]>

Kidney Disease Equitable Access, Prevention, and Research Act of 2012 Short Titles as Introduced Kidney Disease Equitable Access, Prevention, and Research Act of 2012 Display Title Kidney Disease Equitable Access, Prevention, and Research Act of 2012 Official Title as Introduced A bill to amend title XVIII of the Social Security Act to improve Medicare benefits for individuals with kidney disease, and for other purposes. Introduced in Senate 2012-03-06T05:00:00Z https://www.govinfo.gov/content/pkg/BILLS-112s2163is/xml/BILLS-112s2163is.xml 2012-03-06 Read twice and referred to the Committee on Finance. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.