Sponsors (3)
Adds two Medicare-covered home dialysis support services with per-session payment rules tied to the 2025 add-on amount and limited session counts, effective Jan 1, 2028.
Official title: To amend title XVIII of the Social Security Act to include certain additional services as self-care home dialysis support services under the Medicare program.
Introduced May 19, 2026 by Carol Devine Miller · Last progress May 19, 2026
The bill expands Medicare-paid supports for home dialysis (staff-assisted respite and early renal mental health care), improving patient access and provider incentives for home therapy, at the cost of increased federal spending and with limits and payment rules that may leave gaps for some patients and providers.
Medicare beneficiaries receiving home dialysis gain paid coverage for up to 20 staff-assisted respite sessions per year, reducing caregiver burden and making it easier for patients to remain on home dialysis.
Medicare covers up to 4 paid renal mental health sessions for patients starting home dialysis in the first 60 days, addressing psychological barriers to successful home therapy and potentially reducing downstream complications or hospitalizations through more integrated care.
The bill creates an explicit Medicare payment (non–budget-neutral) for these services, increasing provider reimbursement and creating stronger incentives for hospitals and clinicians to offer staff-assisted respite and renal mental health supports.
Taxpayers and the Medicare trust fund will face increased federal spending because the new Medicare payments are explicitly non–budget-neutral.
The statutory limits on services (20 respite sessions per year; 4 mental-health sessions in the first 60 days) may be insufficient for beneficiaries with greater or longer-term needs, leaving some patients without adequate support.
Payments are tied to the 2025 add-on amount and reduced outside rural areas (75% or 25%), which could create geographic payment disparities and result in inadequate reimbursement for providers in many nonrural regions.
Based on analysis of 2 sections of legislative text.
Adds two new Medicare-covered self-care home dialysis support services—staff-assisted home dialysis respite care and renal mental health services—and requires Medicare to pay for each session under specified formulas. Payments are tied to the 2025 home/self-dialysis training add-on amount, have annual/session limits, are non–budget-neutral, and take effect January 1, 2028. Also updates a statutory cross-reference to reflect the new subparagraph structure. The changes expand covered services for people on home dialysis and create explicit per-session payment adjustments under Medicare ESRD payment rules.