[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5018 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 5018

To amend title XVIII of the Social Security Act to clarify and preserve 
 the breadth of the protections under the Medicare Secondary Payer Act.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 11, 2024

Mr. Cassidy (for himself, Mr. Booker, and Mr. Heinrich) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to clarify and preserve 
 the breadth of the protections under the Medicare Secondary Payer Act.

    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 ``Restore Protections for Dialysis 
Patients Act''.

SEC. 2. PURPOSES.

    The purposes of this Act are--
            (1) to clarify and preserve the breadth of the protections 
        under the Medicare Secondary Payer Act;
            (2) to prohibit health insurance plans from shifting 
        primary responsibility for covering the cost of health care 
        services needed by patients with end stage renal disease (ESRD) 
        to the Medicare program; and
            (3) to affirm Congress' intent by clarifying that singling 
        out dialysis services for disfavored treatment through coverage 
        limitations as compared to other covered health services 
        constitutes inappropriate differentiations between the benefits 
        provided to individuals with ESRD and other individuals, but 
        does not change a plan's current ability to limit which renal 
        dialysis providers it includes in the provider network it 
        elects to offer its enrollees.

SEC. 3. CLARIFICATION AND PRESERVATION OF PROHIBITION UNDER THE 
              MEDICARE PROGRAM.

    Section 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 
1395y(b)(1)(C)) is amended--
            (1) by striking clause (ii) and inserting the following new 
        clause:
                            ``(ii) may not differentiate, directly or 
                        indirectly, in the benefits it provides between 
                        individuals obtaining renal dialysis or having 
                        end stage renal disease and other individuals 
                        covered by such plan on the basis of--
                                    ``(I) the diagnosis of end stage 
                                renal disease;
                                    ``(II) the need for renal dialysis; 
                                or
                                    ``(III) in any other manner;''; and
            (2) by adding at the end of the matter following clause 
        (ii) the following new sentences: ``Nothing in this subsection 
        shall be construed as requiring a group health plan to include 
        a particular renal dialysis provider as part of the provider 
        network the group health plan elects to offer its enrollees. 
        The Secretary shall enforce this subparagraph consistent with 
        the nonconformance determination requirements set forth in part 
        411 of title 42, Code of Federal Regulations.''.
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