Congress·In Committee·S. 1173

Sens. Cassidy and Booker Introduce Bill to Stop Insurers from Cutting Dialysis Coverage

Restore Protections for Dialysis Patients Act

12 months ago·View on Congress.gov

Legislative Progress

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Key Points

This bipartisan bill, introduced by Senators Cassidy, Booker, Cramer, and Heinrich, would stop private health insurance companies from offering worse coverage for dialysis than for other medical services. It aims to protect people with end-stage renal disease (permanent kidney failure) from being singled out by their insurance plans.
From policy text
“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.”
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The bill prevents insurance companies from shifting the cost of dialysis to the government-run Medicare program. By keeping private plans responsible for covering these costs, the bill helps protect taxpayer dollars and ensures patients can keep their existing private coverage.
From policy text
“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.”
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Insurance companies would be banned from creating benefit limits that specifically hurt people who need dialysis, including limits on network composition that disproportionately affect them. However, insurers still have the right to choose which specific dialysis clinics are in their network.
From policy text
“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.”
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The bill amends the Social Security Act to clarify that plans cannot differentiate benefits — or have policies that have the effect of differentiating — between people with end-stage renal disease and other enrollees.

HealthcareEconomy Finance

Impact Analysis

Personal Impact

Who is affectedScoreImpactCertaintyScopeDurationSentiment

Scores: 1 = low, 5 = highSentiment: -5 to +5 (net benefit)

Milestones

2 milestones2 actions

Mar 27, 2025Senate

Read twice and referred to the Committee on Finance.

Mar 27, 2025

Introduced in Senate

Related News

5 articles

Healio·over 1 year ago

Senate bill would require health plans to continue dialysis coverage for 30 months

The Restore Protections for Dialysis Patients Act would require private health plans to pay for dialysis for beneficiaries with kidney failure for 30 months before transitioning to Medicare. The bill addresses a 2022 Supreme Court ruling that allowed plans to reimburse dialysis at lower rates.

Politico·over 3 years ago

DaVita helped craft new bill to fix 'loophole' left by Supreme Court loss, documents show

Documents show dialysis giant DaVita was heavily involved in drafting the Restore Protections for Dialysis Patients Act shortly after losing a Supreme Court case. The legislation aims to reverse the court's decision allowing employer plans to offer limited coverage for dialysis services.

CL~

Kidney News·about 2 years ago

The 2023 Restore Protections for Dialysis Patients Act aims to protect access to private insurer coverage

Bipartisan legislation aims to ensure vulnerable patients do not face abrupt transitions from private insurance to Medicare. The bill restores Medicare Secondary Payer Act protections by ensuring insurers do not discriminate against ESRD patients or adversely classify dialysis services.

Related Bills

1 bill

H.R. 2199Related bill

Restore Protections for Dialysis Patients Act

Mar 18 — Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.