Purposes

The purposes of this Act are the following: (1) To restore protections under Medicare Secondary Payer provisions for individuals with end-stage renal disease by ensuring that private health plans do not discriminate against such individuals or adversely classify dialysis as compared to other covered medical services. (2) To prohibit health insurance plans from shifting primary responsibility for covering the cost of health care services needed by individuals with end-stage renal disease to the Medicare program. (3) To affirm the intent of Congress by clarifying that singling out dialysis services for disfavored treatment through coverage limitations as compared to other covered health services constitutes inappropriate differentiations between the benefits provided to individuals with end-stage renal disease and other individuals, but does not change a plan’s ability to limit which renal dialysis providers it includes in the provider network it elects to offer its enrollees.