[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1067 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 1067

   To amend title XVIII of the Social Security Act to require renal 
 dialysis facilities to meet hemodialysis standards as a condition of 
 receiving payment for renal hemodialysis services furnished under the 
                           Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 27, 1995

  Mr. Stark introduced the following bill; which was referred to the 
 Committee on 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 require renal 
 dialysis facilities to meet hemodialysis standards as a condition of 
 receiving payment for renal hemodialysis services furnished 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. HEMODIALYSIS STANDARDS FOR MEDICARE RENAL DIALYSIS 
              FACILITIES.

    (a) Requiring Facilities To Meet Standards.--Section 1881(b)(1) of 
the Social Security Act (42 U.S.C. 1395rr(b)(1)) is amended by striking 
the period at the end of the second sentence and inserting ``, and 
requirements for adequate hemodialysis in accordance with standards 
under paragraph (12).''.
    (b) Standards Described.--Section 1881(b) of such Act (42 U.S.C. 
1395rr(b)) is amended by adding at the end the following new paragraph:
            ``(12)(A) For purposes of paragraph (1), a provider of 
        services or renal dialysis facility meets the standards for 
        adequate hemodialysis under this paragraph for a cost reporting 
        period if, during the preceding cost reporting period, it 
        certifies that for not less than 50 percent of all the 
        individuals receiving hemodialysis services from the facility 
        during the reporting period--
                    ``(i) KT/V, defined as a fraction of body water 
                cleared of urea during dialysis, was not less than 1.2, 
                where `K' equals the urea clearance, `T' equals the 
                duration of the dialysis, and `V' equals the volume of 
                distribution of urea;
                    ``(ii) in the case of a provider of services or 
                facility which the Secretary finds may be unable to 
                implement the formula described in clause (i) without 
                incurring additional costs, the urea reduction ratio 
                (URR) was not less than 0.65, where the URR is defined 
                as the predialysis urea concentration minus the 
                postdialysis urea concentration divided by the 
                predialysis urea concentration, or
                    ``(iii) the provider of services or facility 
                maintains appropriate documentation of blood clearance 
                in each patient's medical records file and makes such 
                data available for review by the appropriate end stage 
                renal disease network.
            ``(B) At any time, the Secretary may apply alternative 
        standards for adequate blood clearance under this paragraph for 
        a cost reporting period if the Secretary certifies to Congress 
        that the alternative standards are more medically appropriate 
        than the standards described in subparagraph (A) for 
        determining the quality of hemodialysis services furnished to 
        individuals under this title.
            ``(C) For reporting periods after January 1, 1998, the 50 
        percent requirement in subparagraph (A) shall be increased to 
        75 percent.''.

SEC. 2. EFFECTIVE DATE.

    The amendments made by section 1 shall apply to services furnished 
during portions of cost reporting periods beginning on or after January 
1, 1997.
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