[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4185 Introduced in House (IH)]







104th CONGRESS
  2d Session
                                H. R. 4185

 To amend title XVIII of the Social Security Act to pay for parenteral 
   nutrients provided as part of renal dialysis services as part of 
    payment for renal dialysis services under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 25, 1996

  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 pay for parenteral 
   nutrients provided as part of renal dialysis services as part of 
    payment for renal dialysis services 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. SHORT TITLE.

    This Act may be cited as the ``Medicare Intradialytic Parenteral 
Nutrient Act of 1996''.

SEC. 2. INTRADIALYTIC PARENTERAL NUTRIENTS REIMBURSED UNDER COVERAGE 
              FOR RENAL DIALYSIS SERVICES UNDER MEDICARE.

    (a) In General.--Section 1881(b)(11) of the Social Security Act (42 
U.S.C. 1395rr(b)(11)) is amended by adding at the end the following:
    ``(D)(i) Intradialytic parenteral nutrients (including related 
services, supplies and equipment), when provided to a patient 
determined to have end stage renal disease, shall not be included as a 
dialysis service for purposes of payment under any prospective payment 
amount or comprehensive fee established under this section, and payment 
for such item shall be made separately--
            ``(I) in the case of such nutrients provided by a 
        physician, in accordance with section 1833; and
            ``(II) in the case of such nutrients provided by an entity 
        other than a physician, an amount equal to 80 percent of an 
        amount based on the lesser of the best price available for such 
        nutrients or the arms-length acquisition cost of such nutrients 
        plus an appropriate administration fee, as determined by the 
        Secretary.
    ``(ii)(I) By not later than January 1, 1998, the Secretary, in 
consultation with medical experts, shall establish criteria to 
determine medically appropriate uses of such nutrients when provided to 
a patient determined to have end stage renal disease.
    ``(II) No payment shall be made under this title for such nutrients 
on or after January 1, 1999, unless the use of such nutrients meets the 
criteria for medically appropriate uses established under subclause 
(I).
    ``(III) The Secretary, in consultation with medical experts, shall 
review and modify such criteria as necessary when new relevant 
scientific data becomes available.''.
    (b) Effective Date.--The amendment made by subsection (a) applies 
with respect to payments for intradialytic parenteral nutrients 
provided on or after January 1, 1997.
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