END-STAGE RENAL DISEASE AMENDMENTS.

SEC. 4036. END-STAGE RENAL DISEASE AMENDMENTS. (a) Implementation of Primary Payer Requirements for Endstage Renal Disease Program.— (1) Section 1862(b)(2)(A) of the Social Security Act (42 U.S.C. 1395y(b)(2)(A)) is amended by striking “(ii)” and all that follows through “under this title” and inserting “(ii) can reasonably be expected to be made under such a plan”. (2) The amendment made by paragraph (1) shall apply with respect to items and services furnished on or after 30 days after the date of the enactment of this Act. (b) Limitation of Minimum Utilization Rate Requirement for End-Stage Renal Disease Transplantations.— The last sentence of section 1881(b)(1) of such Act (42 U.S.C. 1395rr(b)(1)) is amended by striking “covered procedures and for self-dialysis training programs” and inserting “transplantations”. (c) Extension of Deadline for Establishing Protocols on Reuse of Dialysis Filters and Other Dialysis Supplies as it Relates to the Reuse of Bloodunes.— (1) (A) Section 9335(k)(2) of the Omnibus Budget Reconciliation Act of 1986 is amended by inserting “(or July 1, 1988, with respect to protocols that relate to the reuse of bloodlines)” after “October 1, 1987”. (B) The amendment made by subparagraph (A) shall be effective as if included in the enactment of section 9335(k)(2) of the Omnibus Budget Reconciliation Act of 1986. (2) Section 1881(f)(7)(B) of the Social Security Act (42 U.S.C. 1395rr(f)(7)(B)) is amended by inserting “(or July 1, 1988, with respect to protocols that relate to the reuse of bloodlines)” after “January 1, 1988”. (d) Studies of End-Stage Renal Disease Program.— (1) The Secretary of Health and Human Services (in this subsection referred to as the “Secretary”) shall arrange for a study of the end-stage renal disease program within the medicare program. (2) Among other items, the study shall address— (A) access to treatment by both individuals eligible for medicare benefits and those not eligible for such benefits; (B) the quality of care provided to end-stage renal disease beneficiaries, as measured by clinical indicators, functional status of patients, and patient satisfaction; (C) the effect of reimbursement on quality of treatment; (D) major epidemiological and demographic changes in the end-stage renal disease population that may affect access to treatment, the quality of care, or the resource requirements of the program; and (E) the adequacy of existing data systems to monitor these matters on a continuing basis. (3) The Secretary shall submit to Congress, not later than 3 years after the date of the enactment of this Act, a report on the study. (4) The Secretary shall request the National Academy of Sciences, acting through the Institute of Medicine, to submit an application to conduct the study described in this section. If the101 STAT. 1330–80 Academy submits an acceptable application, the Secretary shall enter into an appropriate arrangement with the Academy for the conduct of the study. If the Academy does not submit an acceptable application to conduct the study, the Secretary may request one or more appropriate nonprofit private entities to submit an application to conduct the study and may enter into an appropriate arrangement for the conduct of the study by the entity which submits the best acceptable application. (5) Section 1881 of the Social Security Act (42 U.S.C. 1395rr) is amended— (A) in subsection (c)(2)(F), by striking “and subsection (g)”, (B) by striking the last sentence of subsection (c)(6), (C) by striking subsection (g), and (D) by redesignating subsection (h), as added by section 20 of the Medicare and Medicaid Patient and Program Protection Act of 1987 (Public Law 100–93), as subsection (g).