Improving Home Dialysis Act of 2026

Key Points

• Starting January 1, 2028, Medicare would cover staff-assisted home dialysis respite care for patients who are temporarily unable to do their own dialysis at home. Qualified nurses or trained technicians would come to a patient's home to help with treatment.
• Patients starting home dialysis could get up to 20 sessions of professional help per year during their first 30 days, or at any time if they have a physical limitation that temporarily prevents them from doing dialysis on their own.
• The bill also adds Medicare coverage for mental health services for patients starting home dialysis, covering up to 4 sessions during the first 60 days to help patients adjust emotionally to managing their own care at home.
• Rural patients would get higher Medicare payment rates for these new services. In rural areas, providers would receive the full add-on payment for respite care and 50% for mental health services, compared to 75% and 25% respectively in non-rural areas.
• The new payment adjustments would not be budget neutral, meaning the cost of these new services would be added on top of existing Medicare spending rather than offset by cuts to other dialysis payments.