H.R. 8376

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8376 Introduced in House (IH)]

<DOC>

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.''.
<all>