What does Preamble of Restore Protections for Dialysis Patients Act do?

This bill, formally titled 'To amend title XVIII of the Social Security Act to clarify and preserve the breadth of the protections under the Medicare Secondary Payer Act,' aims to amend title XVIII of the Social Security Act. The bill intends to clarify and preserve the protections provided by the Medicare Secondary Payer Act.

What does SHORT TITLE. of Restore Protections for Dialysis Patients Act do?

This bill is formally titled the Restore Protections for Dialysis Patients Act.

What does PURPOSES. of Restore Protections for Dialysis Patients Act do?

This Act aims to restore Medicare Secondary Payer protections for individuals with end-stage renal disease. It seeks to prevent private health plans from discriminating against individuals with end-stage renal disease or unfairly classifying dialysis. The Act prohibits health insurance plans from shifting healthcare cost responsibility for individuals with end-stage renal disease to Medicare. It clarifies that singling out dialysis for coverage limitations is inappropriate but does not restrict a plan's ability to manage its provider network.

What does CLARIFICATION AND PRESERVATION OF PROHIBITION UNDER THE of Restore Protections for Dialysis Patients Act do?

This section amends Section 1862(b)(1)(C) of the Social Security Act. The amendment strikes existing clause (ii) and replaces it with a new clause (ii) that prohibits Medicare plans from differentiating benefits between individuals with end-stage renal disease and other covered individuals. The new clause (ii) prohibits plans from differentiating benefits based on diagnosis or need for renal dialysis. The amendment adds a clause stating that group health plans are not required to include a specific renal dialysis provider or number of providers in their network. The Secretary is tasked with enforcing the new subparagraph consistent with nonconformance determination requirements outlined in 42 C.F.R. part 411.

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Restore Protections for Dialysis Patients Act

Last updated: 3/27/2025 · Introduced: 3/27/2025

Author: Bill Cassidy (R-LA)

TL;DR (AI)

This bill prevents health insurance plans from shifting healthcare cost responsibility for individuals with end-stage renal disease to Medicare.
It prohibits Medicare plans from differentiating benefits between individuals with end-stage renal disease and other covered individuals, based on diagnosis or need for renal dialysis.
The bill clarifies that group health plans are not required to include a specific renal dialysis provider or number of providers in their network.

119th Congressin committeeHR. 2199(In Committee)Official page

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Other Sections

Includes provisions on preamble, short title., and 2 more.

4 sections

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