Improving Home Dialysis Act of 2026

[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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