Summary: H.R.6537 — 111th Congress (2009-2010)All Information (Except Text)

There is one summary for H.R.6537. Bill summaries are authored by CRS.

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Introduced in House (12/16/2010)

Improving Care for Kidney Patients Act of 2010 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act with respect to kidney disease benefits.

Sets at 100% the federal medical assistance percentage (FMAP) with respect to the placement of an arteriovenous fistula or graft in the hemodialysis treatment of Medicaid beneficiaries.

Directs the Secretary of Health and Human Services (HHS), acting through the Director of the Agency for Healthcare Research and Quality, to study and report to Congress on: (1) the social, behavioral, and biological factors leading to kidney disease; (2) efforts to slow the progression of kidney disease in minority populations that are disproportionately affected by it; and (3) research gaps in the development of quality measures and care management for patients with end-stage renal disease (ESRD), including pediatric patients.

Amends the Social Security Act, with respect to criminal penalties for certain acts, to exclude from the meaning of illegal remuneration the waiver of any fee or cost-sharing by a renal dialysis facility (RDF) in providing chronic kidney disease screening that meets certain criteria.

Treats as a hospital for Medicare purposes an institution providing Medicare or Medicaid patients diagnosed with stage IV or stage V kidney disease with educational materials about treatment. Treats as a person qualified to furnish kidney disease education services an RDF meeting specified criteria.

Makes eligible to participate in a shared savings program as an accountable care organization (ACO) a group consisting of RDFs, nephrologists, and other service providers and suppliers that treat patients with kidney disease.

Prescribes Medicare requirements for coordination of care between hospitals and RDFs for the discharge planning process for an ESRD patient.

Specifies Medicare coverage to specialized occlusive dressings used by a patient receiving dialysis treatment for protection against life threatening catheter-related infections during maintenance of personal hygiene at home.

Directs the Comptroller General to evaluate and report to Congress on the transportation barriers facing dialysis patients that result in less than 100% compliance with a Medicare plan of care.

Directs the Secretary, in specified circumstances, to accept the results of a state licensure survey for purposes of determining federal certification of an RDF's compliance with the conditions of Medicare participation.

Directs the Secretary of HHS to report to Congress on the benefits of recognizing dialysis vascular and peritoneal dialysis access care service sites in order to receive Medicare reimbursement.

Revises Medicare requirements for group health plans to: (1) extend the period during which they are primary payers (and Medicare the secondary payer) for ESRD patients; and (2) prohibit denial of a Medigap policy to a ESRD patient.

Amends the Public Health Service Act, as amended by the Patient Protection and Affordable Care Act, to allow a group health plan or health insurance issuer to impose restrictions for kidney failure treatment on a participant, beneficiary, or enrollee only if they are reasonable and assure adequate access to out-of-network providers.