[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8376 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 8376
To amend title XVIII of the Social Security Act to clarify the policy
for coverage under the Medicare program for palliative dialysis
services, and clarify separate payment for such palliative dialysis
services, furnished by renal dialysis facilities and providers of
services to certain individuals electing hospice care, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 20, 2026
Mr. Kelly of Pennsylvania (for himself and Ms. DelBene) introduced the
following bill; which was referred to the Committee on Ways and Means,
and in addition to the Committee on Energy and Commerce, 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 clarify the policy
for coverage under the Medicare program for palliative dialysis
services, and clarify separate payment for such palliative dialysis
services, furnished by renal dialysis facilities and providers of
services to certain individuals electing hospice care, and for other
purposes.
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 ``Concurrent Care for Comfort Act''.
SEC. 2. CLARIFICATION AND APPLICATION OF POLICY PROVIDING FOR COVERAGE
OF CONCURRENT PALLIATIVE DIALYSIS SERVICES AND HOSPICE
CARE TO INDIVIDUALS ELECTING HOSPICE CARE.
(a) In General.--Section 1812(d)(2)(A) of the Social Security Act
(42 U.S.C. 1395d(d)(2)(A)) is amended by inserting ``, to palliative
dialysis services (as defined in section 1881(b)(15)(E)) furnished by a
provider of services or renal dialysis facility to a palliative
dialysis eligible individual (as defined in such section),'' after
``(if not an employee of the hospice program)''.
(b) Separate Payment for Palliative Dialysis Services Furnished by
Providers of Services and Kidney Dialysis Facilities.--
(1) Payment separate from hospice care bundle.--Section
1814(i) of the Social Security Act (42 U.S.C. 1395f(i)) is
amended by adding at the end the following new paragraph:
``(8) In the case of palliative dialysis services (as
defined in section 1881(b)(15)(E)) furnished by a provider of
services or renal dialysis facility to a palliative dialysis
eligible individual (as defined in such section) during a
period of an election under section 1812(d)(1) made by such
individual, the provider of services or renal dialysis facility
shall bill and be paid for such dialysis in accordance with
section 1881(b)(15).''.
(2) Payment methodology.--Section 1881(b) of the Social
Security Act (42 U.S.C. 1395r(b)) is amended by adding at the
end the following new paragraph:
``(15) Payment for palliative dialysis services furnished
to individuals electing hospice care.--
``(A) In general.--For 2026 and each subsequent
year, the Secretary shall, taking into account the
assessment and considerations described in subparagraph
(B) and pursuant to rulemaking, establish a methodology
for determining, with respect to a palliative dialysis
eligible individual whose election under section
1812(d)(1) to receive hospice care is for a period
occurring during such year, the payment amounts under
this title for palliative dialysis services furnished
by a provider of services or renal dialysis facility
during such period to such individual in a facility or
to such individual at home.
``(B) Considerations.--In implementing the
methodology under subparagraph (A), the Secretary
shall--
``(i) consider calculating payment amounts
for such services based on the amounts that
would otherwise be calculated under the system
established under paragraph (14) for comparable
renal dialysis services described in such
paragraph; and
``(ii) consider, after assessing the
resources directly or indirectly related to
furnishing palliative dialysis services
necessary for providers of services and renal
dialysis facilities to furnish palliative
dialysis services to palliative dialysis
eligible individuals in a facility or to such
individuals at home, any adjustments that
should be applied in calculating such payments
amounts based on such assessment.
``(C) Limitations.--
``(i) In general.--Subject to clause (ii),
payment may not be made under this title for
more than ten sessions of palliative dialysis
services furnished to a palliative dialysis
eligible individual. In the case of home
dialysis, including peritoneal dialysis, this
subparagraph shall be applied by converting the
number of days of such dialysis to hemodialysis
equivalent sessions, in accordance with the
methodology specified in section 50 of Chapter
11 of the Medicare Benefit Policy Manual, or
any successor to such section.
``(ii) Secretarial authority to modify
limitation.--
``(I) Assessment and
determination.--For 2029 the Secretary
shall (and for any subsequent year, the
Secretary may) pursuant to rulemaking--
``(aa) assess the
appropriateness of the
limitation specified under
clause (i) for such year, based
on data on determinations
regarding coverage of
palliative dialysis services
furnished to palliative
dialysis eligible individuals
pursuant to this paragraph and
stakeholder feedback on such
coverage; and
``(bb) based on such
assessment, determine for such
year whether to apply a limit
on the number of sessions of
palliative dialysis services
(other than the number
specified under clause (i))
and, if so, specify such other
number that is to be applied
for such year.
``(II) Application of modified
number limit.--For any year for which
the Secretary specifies a number
pursuant to subclause (I)(bb) other
than the number specified in clause
(i), clause (i) shall be applied as if
the reference to ten sessions were a
reference to such different number of
treatments specified by the Secretary.
``(D) Cost-sharing.--Under the methodology under
subparagraph (A), the deductible and coinsurance
provisions under this title that would apply with
respect to kidney dialysis services for which payment
may be made under this section (other than this
paragraph) shall also apply with respect to palliative
dialysis services furnished to a palliative dialysis
eligible individual for which payment is made pursuant
to this paragraph.
``(E) Palliative dialysis services and palliative
dialysis eligible individual defined.--For purposes of
this paragraph:
``(i) Palliative dialysis services.--The
term `palliative dialysis services' means, with
respect to a palliative dialysis eligible
individual, dialysis services specified by the
Secretary that are furnished to the individual
(in a facility or at home) as palliative care,
and not for purposes of treatment or
maintenance, in accordance with a plan of care
certified by the individual's physician in
consultation with the interdisciplinary group
described in section 1861(dd)(2)(B), and which
may include other services specified by the
Secretary, such as non-emergency transportation
for which payment would otherwise be available
under this section in connection with receipt
of maintenance dialysis services.
``(ii) Palliative dialysis eligible
individual.--The term `palliative dialysis
eligible individual' means an individual with
end-stage renal disease who makes an election
under section 1812(d)(1) and who as of the date
of such election was receiving renal dialysis
services (as described in section
1881(b)(14)(B)).
``(F) Clarification.--None of the provisions of
this paragraph shall affect coverage or payment under
this title which would otherwise apply for renal
dialysis services for treatment or maintenance for
individuals with end-stage renal disease who make an
election for hospice care under section 1812(d)(1) on
the basis of a primary health condition other than a
terminal condition that is not related to end-stage
renal disease.''.
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