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Restore Protections for Dialysis Patients Act
To amend title XVIII of the Social Security Act to clarify and preserve the breadth of the protections under the Medicare Secondary Payer Act.
Summary
This bill clarifies protections under the Medicare Secondary Payer Act to prevent private health plans from discriminating against individuals with end-stage renal disease. The bill prohibits health plans from singling out dialysis services for disfavored treatment, such as coverage limitations that do not apply to other covered medical services. It also prohibits health plans from shifting primary responsibility for covering end-stage renal disease treatment costs to the Medicare program. The bill clarifies that health plans can still limit which dialysis providers they include in their networks, even as they must provide equal benefits for dialysis compared to other services. The Secretary of Health and Human Services would enforce these protections under existing regulatory procedures.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Sen. Cassidy, Bill [R-LA] (R-LA)
7 cosponsors
- Sen. Blackburn, Marsha [R-TN] (R-TN)
- Sen. Booker, Cory A. [D-NJ] (D-NJ)
- Sen. Budd, Ted [R-NC] (R-NC)
- Sen. Cramer, Kevin [R-ND] (R-ND)
- Sen. Heinrich, Martin [D-NM] (D-NM)
- Sen. Hyde-Smith, Cindy [R-MS] (R-MS)
- Sen. Marshall, Roger [R-KS] (R-KS)
Money behind the sponsor
Top reported contributors to Bill Cassidy’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
- ANDREESSEN HOROWITZ $59,100
- GENERAL ATLANTIC $37,700
- WELSH CARSON ANDERSON & STOWE $33,870
- OCHSNER HEALTH SYSTEM $33,250
- RA CAPITAL MANAGEMENT $30,200
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Bill Cassidy → · Outside spending →
Actions (2)
- Mar 27, 2025 Read twice and referred to the Committee on Finance. · senate
- Mar 27, 2025 Introduced in Senate
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
IN THE SENATE OF THE UNITED STATES
March 27, 2025
Mr. Cassidy (for himself, Mr. Booker, Mr. Cramer, and Mr. Heinrich) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to clarify and preserve the breadth of the protections under the Medicare Secondary Payer Act.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Restore Protections for Dialysis Patients Act”.
SEC. 2. 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.
SEC. 3. CLARIFICATION AND PRESERVATION OF PROHIBITION UNDER THE MEDICARE PROGRAM.
Section 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 1395y(b)(1)(C)) is amended—
(1) by striking clause (ii) and inserting the following:
“(ii) may not on any basis (including the diagnosis of end-stage renal disease or the need for renal dialysis) or in any manner—
“(I) differentiate (or have the effect of differentiating) in the benefits it provides between individuals having end stage renal disease and other individuals covered by such plan; or
“(II) apply a limitation on benefits (including on network composition) under the plan that will disparately affect individuals having end-stage renal disease;”; and
(2) by adding at the end of the matter following clause
(ii) the following: “Nothing in this subsection shall be construed as requiring a group health plan to include a particular renal dialysis provider or a particular number of renal dialysis providers as part of the provider network the group health plan elects to offer its enrollees. The Secretary shall enforce this subparagraph consistent with the nonconformance determination requirements described in part 411 of title 42, Code of Federal Regulations (or any successor regulation).”. <all>
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