Us Congress 2025-2026 Regular Session

Us Congress Senate Bill SB1173 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	II
2	2	119THCONGRESS
3	3	1
4	4	STSESSION S. 1173
5	5	To amend title XVIII of the Social Security Act to clarify and preserve
6	6	the breadth of the protections under the Medicare Secondary Payer Act.
7	7	IN THE SENATE OF THE UNITED STATES
8	8	MARCH27, 2025
9	9	Mr. C
10	10	ASSIDY(for himself, Mr. BOOKER, Mr. CRAMER, and Mr. HEINRICH)
11	11	introduced the following bill; which was read twice and referred to the
12	12	Committee on Finance
13	13	A BILL
14	14	To amend title XVIII of the Social Security Act to clarify
15	15	and preserve the breadth of the protections under the
16	16	Medicare Secondary Payer Act.
17	17	Be it enacted by the Senate and House of Representa-1
18	18	tives of the United States of America in Congress assembled, 2
19	19	SECTION 1. SHORT TITLE. 3
20	20	This Act may be cited as the ‘‘Restore Protections 4
21	21	for Dialysis Patients Act’’. 5
22	22	SEC. 2. PURPOSES. 6
23	23	The purposes of this Act are the following: 7
24	24	(1) To restore protections under Medicare Sec-8
25	25	ondary Payer provisions for individuals with end- 9
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28	28	•S 1173 IS
29	29	stage renal disease by ensuring that private health 1
30	30	plans do not discriminate against such individuals or 2
31	31	adversely classify dialysis as compared to other cov-3
32	32	ered medical services. 4
33	33	(2) To prohibit health insurance plans from 5
34	34	shifting primary responsibility for covering the cost 6
35	35	of health care services needed by individuals with 7
36	36	end-stage renal disease to the Medicare program. 8
37	37	(3) To affirm the intent of Congress by clari-9
38	38	fying that singling out dialysis services for 10
39	39	disfavored treatment through coverage limitations as 11
40	40	compared to other covered health services constitutes 12
41	41	inappropriate differentiations between the benefits 13
42	42	provided to individuals with end-stage renal disease 14
43	43	and other individuals, but does not change a plan’s 15
44	44	ability to limit which renal dialysis providers it in-16
45	45	cludes in the provider network it elects to offer its 17
46	46	enrollees. 18
47	47	SEC. 3. CLARIFICATION AND PRESERVATION OF PROHIBI-19
48	48	TION UNDER THE MEDICARE PROGRAM. 20
49	49	Section 1862(b)(1)(C) of the Social Security Act (42 21
50	50	U.S.C. 1395y(b)(1)(C)) is amended— 22
51	51	(1) by striking clause (ii) and inserting the fol-23
52	52	lowing: 24
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55	55	•S 1173 IS
56	56	‘‘(ii) may not on any basis (including 1
57	57	the diagnosis of end-stage renal disease or 2
58	58	the need for renal dialysis) or in any man-3
59	59	ner— 4
60	60	‘‘(I) differentiate (or have the ef-5
61	61	fect of differentiating) in the benefits 6
62	62	it provides between individuals having 7
63	63	end stage renal disease and other in-8
64	64	dividuals covered by such plan; or 9
65	65	‘‘(II) apply a limitation on bene-10
66	66	fits (including on network composi-11
67	67	tion) under the plan that will dispar-12
68	68	ately affect individuals having end- 13
69	69	stage renal disease;’’; and 14
70	70	(2) by adding at the end of the matter following 15
71	71	clause (ii) the following: ‘‘Nothing in this subsection 16
72	72	shall be construed as requiring a group health plan 17
73	73	to include a particular renal dialysis provider or a 18
74	74	particular number of renal dialysis providers as part 19
75	75	of the provider network the group health plan elects 20
76	76	to offer its enrollees. The Secretary shall enforce 21
77	77	this subparagraph consistent with the nonconform-22
78	78	ance determination requirements described in part 23
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81	81	•S 1173 IS
82	82	411 of title 42, Code of Federal Regulations (or any 1
83	83	successor regulation).’’. 2
84	84	Æ
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