Sponsors (2)
The bill enables Medicare-covered palliative dialysis for hospice patients and creates a billing pathway to support those services, but it imposes cost-sharing, an initial session cap, and leaves key payment details to later rulemaking—potentially limiting access and financial protection for some beneficiaries.
Medicare beneficiaries with end-stage renal disease (ESRD) who elect hospice can receive palliative dialysis billed separately, preserving access to symptom-focused dialysis while on hospice.
Providers and dialysis facilities can bill Medicare for palliative dialysis (in-facility or at home), creating a clear payment pathway that may help sustain availability of palliative dialysis services.
The required payment methodology must consider resource needs and the existing dialysis payment system, which could better align payments with the actual costs of providing palliative dialysis.
The bill applies Medicare deductible and coinsurance rules to palliative dialysis, so Medicare beneficiaries may face out-of-pocket cost-sharing for these services.
An initial cap of 10 hemodialysis-equivalent sessions per beneficiary could limit access to needed palliative dialysis for some patients.
If payments are set based on the existing dialysis payment system without adequate adjustment, payments may not fully cover the higher costs of home-based or palliative-focused care.
Based on analysis of 2 sections of legislative text.
Authorizes separate Medicare payment starting 2026 for defined palliative dialysis services provided to beneficiaries who elect hospice, with an initial cap of 10 hemodialysis-equivalent sessions.
Official title: To amend title XVIII of the Social Security Act to clarify the policy for coverage under the Medicare program for palliative dialysis services, and clarify separate payment for such palliative dialysis services, furnished by renal dialysis facilities and providers of services to certain individuals electing hospice care, and for other purposes.
Introduced April 20, 2026 by Mike Kelly · Last progress April 20, 2026
Allows Medicare to pay separately for defined “palliative dialysis services” for people who elect hospice, starting in 2026. It requires the Secretary to create a payment method (including for in-facility and home dialysis), generally caps payments at the equivalent of 10 hemodialysis sessions per beneficiary (with conversion rules for home dialysis), applies standard Medicare deductible/coinsurance rules, and clarifies that routine dialysis for end-stage renal disease (ESRD) provided as treatment/maintenance is unchanged when hospice is for a non-ESRD condition.