Bill Peckham
Joined: 06 Jan 2003
Posts: 65
Posted: Tue Mar 04, 2003 9:04 am Post subject: HR 1004 was HR 1759
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I wanted to clarify that the Kidney Patient Daily Dialysis Quality Act of 2003 was introduced in House of Representatives on Fe
uary 27th as HR Bill 1004. Each Congress (this is the 108th) starts from scratch; Bills left over from the previous Congress must be reintroduced.<
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>I?m proud that half of the Washington delegation is listed as sponsors of the Bill. If your Representative is not listed please write and urge their support of this legislation.<
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>Here is the URL where I viewed the text of the Bill:<
>thomas.loc.gov/cgi-bin/qu...08Wclp1s:: <
>or go to <
>thomas.loc.gov/<
>and search for "Daily Dialysis Quality"<
> Edited by: Bill Peckham at: 3/4/03 12:06:49 pm<
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brenda
Joined: 28 Oct 2002
Posts: 103
Posted: Tue Mar 04, 2003 10:44 am Post subject: were they trying to confuse us with changing the #'s
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easy to find when you go to the sites listed above--I did manage to copy one section of it and will paste it below<
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>Kidney Patient Daily Dialysis Quality Act of 2003 (Introduced in House)<
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>HR 1004 IH <
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>108th CONGRESS<
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>1st Session<
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>H. R. 1004<
>To amend title XVIII of the Social Security Act to provide for payment under the Medicare Program for more frequent hemodialysis treatments. <
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>IN THE HOUSE OF REPRESENTATIVES<
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>Fe
uary 27, 2003<
>Mr. MCDERMOTT (for himself, Ms. DUNN, Mr. LEWIS of Georgia, Mr. CUMMINGS, Mr. DICKS, Mr. RANGEL, Mr. MCNULTY, Mr. GOODE, Mr. HASTINGS of Washington, Mr. INSLEE, Mr. KIRK, and Mrs. CHRISTENSEN) 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 <
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>A BILL<
>To amend title XVIII of the Social Security Act to provide for payment under the Medicare Program for more frequent hemodialysis treatments. <
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>Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,<
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>SECTION 1. SHORT TITLE.<
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>This Act may be cited as the `Kidney Patient Daily Dialysis Quality Act of 2003'.<
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>SEC. 2. COVERAGE OF MORE FREQUENT HEMODIALYSIS TREATMENTS.<
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>(a) IN GENERAL- Section 1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended--<
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>(1) in the first sentence of paragraph (7), by inserting before the period the following: `, including payment for more frequent hemodialysis furnished to qualified individuals under paragraph (12)'; and<
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>(2) by adding at the end the following new paragraph:<
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>`(12)(A)(i) Not later than the date that is 1 year after the date of enactment of this paragraph, the Secretary shall cause to have published in the Federal Register final regulations for equivalent per treatment prospective payment rates for more frequent hemodialysis furnished at home and furnished in a facility (commonly known as composite `Method I' rates and `Method II Cap' payment rates), and prospective payment rates for in-facility training for more frequent hemodialysis.<
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>`(ii) For the year beginning more than 12 months after the date described in clause (i), and for each subsequent year, the Secretary shall provide for an appropriate update to the per treatment prospective payment rates developed under clause (i).<
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>`(B) In developing per treatment prospective payment rates under subparagraph (A), the Secretary shall consider--<
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>`(i) actual reasonable costs of operating more frequent hemodialysis programs; and<
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>`(ii) data from the Health Care Financing Administration on actual expenditures under this title for more frequent hemodialysis patients, compared to--<
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>`(I) data on expenditures for the same patients before those patients underwent more frequent hemodialysis, and<
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>`(II) data on expenditures for patients undergoing hemodialysis treatment 3 times per week with similar clinical and demographic characteristics.<
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>`(C) Not later than 1 year after the date of enactment of this paragraph, the Secretary shall develop, in consultation with the renal community, a standard of care and quality standards for more frequent hemodialysis. The Secretary shall periodically review and update as necessary such standards.<
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>`(D) The Secretary shall collect data with respect to--<
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>`(i) documented savings in expenditures under this title by reason of more frequent hemodialysis that are attributable to reduced medications, hospitalizations, outpatient services, and such other factors as the Secretary determines appropriate; and<
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>`(ii) the improved quality of care and improved outcomes more frequent hemodialysis may
ing to patients.<
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>`(E) In this paragraph:<
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>`(i) The term `more frequent hemodialysis' means hemodialysis treatment sessions, or equivalent therapy requiring blood access, performed at least 5 times per week.<
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>`(ii) The term `qualified individual' means an individual who, in the clinical judgment of the physician of the individual, is likely to achieve better clinical outcomes, quality of life outcomes, or both from more frequent hemodialysis.'.<
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>(b) CONFORMING AMENDMENTS- (1) Section 1881(b)( of the Social Security Act (42 U.S.C. 1395rr(b)( ) is amended by inserting `and more frequent hemodialysis supplies and equipment' after `home dialysis supplies and equipment'.<
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>(2) Section 1881(b)(9) of such Act (42 U.S.C. 1395rr(b)(9)) is amended by inserting `and more frequent hemodialysis support services' after `self-care home dialysis support services'.<
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>(c) EFFECTIVE DATE- The amendments made by this section shall take effect on the date of the enactment of this Act and shall apply with respect to items and services furnished on or after the date that is 1 year after such date of enactment.<
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Patrick
Joined: 04 Mar 2003
Posts: 1
Posted: Tue Mar 04, 2003 11:02 am Post subject: Bill
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I've read over the bill and find the language confusing. Can someone spell out in plain language exactly what this bill is offering? Is it daily short txs, nocturnal, what? Are there any drawbacks? How will this change dialysis as its done now? will it mean patients will now be able to do nocturnal?
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Bill Peckham
Joined: 06 Jan 2003
Posts: 65
Posted: Tue Mar 04, 2003 12:41 pm Post subject: HR 1004
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envirotext.eh.doe.gov/data/uscode/42/1395rr.shtml<
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>Above is a link to the actual legal code (the United States Code-USC) that is being amended. Currently this is the first sentence of Section 7 (referred to as Paragraph 7):<
>Quote:?The Secretary shall provide by regulation for a method (or methods) for determining prospectively the amounts of payments to be made for dialysis services furnished by providers of services and renal dialysis facilities to individuals in a facility and to such individuals at home.?<
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>The amended sentence (if HR 1004 was passed) would read:<
>Quote:?The Secretary shall provide by regulation for a method (or methods) for determining prospectively the amounts of payments to be made for dialysis services furnished by providers of services and renal dialysis facilities
to individuals in a facility and to such individuals at home, including payment for more frequent hemodialysis furnished to qualified individuals under paragraph (12)? <
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>The rest of the HR 1004 would add Paragraph (or Section) 12 to USC 42, Chapter 7, Subchapter 18, Part C. Currently this part of USC 42 ends with Paragraph (or Section) 11. <
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>So when you read Brenda?s post of HR 1004 there are two parts. The first part amends what Medicare is allowed to do - specifically authorizing Medicare to pay for more than 3 treatments a week. I find it interesting that there is nothing in the current law that would preclude Medicare paying for more than three treatments but this specifically tells Medicare that reimbursement for more frequent treatments is allowed, something it appears to me that they could do administratively.<
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>The second part of HR 1004 spells out that within one year of HR 1004?s passage Medicare will publish the new rate/reimbursement policies for more frequent dialysis along with other information. It is my understanding that the new policy would be something along the lines of 1.4 additional treatments being reimbursed. Therefore, if the Acme Dialysis Center provided Joe Patient with 6 treatments a week and their Medicare composite rate was $130/treatment they would receive $572 per week ($130x4.4) instead of the current $390 ($130x3).<
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>I believe that this reimbursement increase would increase the availability of more frequent home dialysis and have no effect on incenter three times a week patients. It would also allow more frequent incenter dialysis to be reimbursed in the same manner so some units might offer incenter more frequent dialysis, something that is currently very rare. If bamboo shoots were inserted under my fingernails I may concede that patients dialyzing in center more frequently could result in the runs of new patients, choosing standard (three times a week) dialysis, to be shortened. Not for reimbursement reasons but to make the scheduling of more frequent patients easier. However, I think this is unlikely and is not a strong reason to stand against or be neutral towards HR 1004.<
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>There is no mention in USC of the duration of a dialysis treatment and this addresses only frequency. So if a provider currently offers nocturnal they could be reimbursed for more frequent nocturnal. Just as they currently offer standard incenter dialysis this bill would allow them to offer and be reimbursed for more frequent incenter dialysis.<
> Edited by: Bill Peckham at: 3/4/03 3:53:34 pm<
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Tue Mar 04, 2003 2:37 pm Post subject: more treatments
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until they put in more specific guide lines i am against giving the industry more money whith out some dtandards. what you would see is the industry shorten the time and give the total weekly time the same. they would very much like to do a 2 to two an half hour treatment. fool me once shame on you fool me twice shame on me. more money does not make a crook honest.
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