H.R. 8875

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8875 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 8875

To amend title XVIII of the Social Security Act to include certain 
additional services as self-care home dialysis support services under 
the Medicare program.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

May 19, 2026

Mrs. Miller of West Virginia introduced the following bill; which was 
referred to the Committee on Energy and 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 include certain 
additional services as self-care home dialysis support 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 ``Improving Home Dialysis Act of 
2026''.

SEC. 2. INCLUDING CERTAIN ADDITIONAL SERVICES AS SELF-CARE HOME 
DIALYSIS SUPPORT SERVICES UNDER THE MEDICARE PROGRAM.

(a) In General.--Section 1881(b)(9) of the Social Security Act (42 
U.S.C. 1395rr(b)(9)) is amended--
(1) in subparagraph (C), by striking ``and'' at the end;
(2) by redesignating subparagraph (D) as subparagraph (F);
(3) by inserting after subparagraph (C) the following new 
subparagraphs:
``(D) beginning January 1, 2028, staff-assisted home 
dialysis respite care furnished to a patient in the place of 
residence used as such patient's home (other than a skilled 
nursing facility or a nursing facility (as defined in section 
1919(a)));
``(E) beginning January 1, 2028, renal mental health 
services furnished to a patient in the place of residence used 
as such patient's home (other than a skilled nursing facility 
or a nursing facility (as defined in section 1919(a))); and''; 
and
(4) by adding at the end the following flush matter:
``For purposes of subparagraph (D), the term `staff-assisted home 
dialysis respite care' means dialysis services furnished by qualified 
personnel to a patient dialyzing at home who is temporarily unable to 
competently dialyze at home independently during the 30-day period 
beginning on the first day that the patient initiates home dialysis 
(or, in the case of a patient whose temporary inability to competently 
dialyze is attributable to a physical limitation, at any time). For 
purposes of the preceding sentence, the term `qualified personnel' 
means a registered nurse, a licensed practical nurse, a certified 
patient care technician, or another qualified medical professional 
specified by the Secretary, who meets requirements (as determined by 
the Secretary) that ensure competency in patient care and modality 
usage, including completing training specific to staff-assisted home 
dialysis respite care as specified by the Secretary. For purposes of 
subparagraph (E), the term `renal mental health services' means 
services described in section 494.90(a)(6) of title 42, Code of Federal 
Regulations (or a successor regulation), furnished to a patient 
dialyzing at home during the 60-day period beginning on the first day 
that the patient initiates home dialysis by an individual who meets the 
standard specified in section 494.140(d) of title 42, Code of Federal 
Regulations (or a successor regulation).''.
(b) Payment Adjustments for Certain Self-care Home Dialysis Support 
Services.--
(1) In general.--Section 1881(b)(14) of the Social Security 
Act (42 U.S.C. 1395rr(b)(14)) is amended--
(A) in subparagraph (D)--
(i) in clause (iii), by striking ``and'' at 
the end;
(ii) by redesignating clause (iv) as clause 
(vi); and
(iii) by inserting after clause (iii) the 
following new clauses:
``(iv) shall include a payment adjustment for staff-
assisted home dialysis respite care (as described in paragraph 
(9)(D)) in accordance with subparagraph (J);
``(v) shall include a payment adjustment for renal mental 
health services (as described in paragraph (9)(E)) in 
accordance with subparagraph (K); and''; and
(B) by adding at the end the following new 
subparagraphs:
``(J)(i) For purposes of subparagraph (D)(iv), subject to clause 
(ii), a payment adjustment shall be made for each session of staff-
assisted home dialysis respite care (as described in paragraph (9)(D)) 
furnished during a year equal to the amount of the add-on per treatment 
adjustment for home and self-dialysis training furnished in 2025 (or, 
in the case of such care that is not furnished in a rural area (as 
defined for purposes of such subparagraph), 75 percent of such amount).
``(ii) In no case may a payment adjustment under subparagraph 
(D)(iv) be made for staff-assisted home dialysis respite care furnished 
to an individual--
``(I) for more than 20 sessions in a calendar year; or
``(II) on a day when such individual was not dialyzing at 
home.
``(iii) Any payment adjustment under subparagraph (D)(iv) for 
staff-assisted home dialysis respite care shall not be made in a budget 
neutral manner.
``(K)(i) For purposes of subparagraph (D)(v), subject to clause 
(ii), a payment adjustment shall be made for each session of renal 
mental health services (as described in paragraph (9)(E)) furnished 
during a year equal to 50 percent (or 25 percent, in the case of such 
services that are not furnished in a rural area (as defined for 
purposes of subparagraph (D))) of the amount of the add-on per 
treatment adjustment for home and self-dialysis training furnished in 
2025.
``(ii) In no case may a payment adjustment under subparagraph 
(D)(v) be made for renal mental health services furnished to an 
individual--
``(I) for more than 4 sessions occurring during the 60-day 
period beginning on the first day that the individual initiates 
home dialysis; or
``(II) on a day when such individual was not dialyzing at 
home.
``(iii) Any payment adjustment under subparagraph (D)(v) for renal 
mental health services shall not be made in a budget neutral manner.''.
(2) Conforming amendment.--Section 1834(r)(1) of the Social 
Security Act (42 U.S.C. 1395m(r)(1)) is amended by striking 
``subparagraph (D)(iv)(II)'' and inserting ``subparagraph 
(D)(vi)(II)''.
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