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HD 4991

An Act relative to Medicare coverage of end-stage renal disease

194th Legislature (2025-2026) Introduced by Tom Stanley

Removes ESRD-only Medicare exclusion from Chapter 176k, expanding coverage for ESRD beneficiaries and aligning them with other Medicare participants upon passage.

Senate concurred
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Bill Summary · HD 4991

Summary: An Act relative to Medicare coverage of end-stage renal disease (HD 4991)

What this bill does

  • This bill would amend Section 1 of Chapter 176k of the Massachusetts General Laws to strike out the language that currently excludes a specific group from eligibility.
  • Specifically, it removes the phrase: “other than a person eligible for Medicare coverage due solely to end-stage renal disease.”
  • The act provides that it takes effect upon passage.

Key provisions and changes

  • Amendment to Chapter 176k, Section 1: The language excluding “a person eligible for Medicare coverage due solely to end-stage renal disease” from whatever benefit/coverage framework is described in that section would be removed.
  • No other sections or programs are amended; the change is narrowly focused on the ESRD-exclusion language.
  • Effective date: Upon passage (no separate delay or transition period specified in the bill).

Who would be affected

  • Individuals who are eligible for Medicare specifically because of end-stage renal disease (ESRD-only Medicare beneficiaries).
  • Depending on the broader program in Chapter 176k, these individuals would no longer be categorically excluded from the coverage or benefits described in the section, aligning their treatment with other Medicare beneficiaries under the same framework.
  • State program administrators and insurers operating under the referenced section may experience updated eligibility determinations and administrative processes as a result.

Procedural and timeline context

  • Introduction: August 7, 2025.
  • Legislative actions:
    • August 7, 2025: Referred to the House Rules Committee.
    • August 14, 2025: Reported, referred to the committee on Joint Rules, with rules suspended and referred to the committee on Health Care Financing.
    • August 18, 2025: Senate concurred.
  • Status: Senate concurred (as of August 18, 2025); the bill is in the Senate’s concurrence stage following committee actions.

Practical implications

  • The bill removes an exclusion, potentially broadening access to a covered benefit or program for ESRD patients who qualify for Medicare solely due to ESRD.
  • Could reduce administrative distinctions between ESRD-only Medicare beneficiaries and other Medicare beneficiaries within the scope of the affected section.
  • No explicit fiscal impact is detailed in the text provided; any cost implications would depend on how the broader coverage framework in Chapter 176k operates for other Medicare beneficiaries.

If you’d like, I can add a brief note explaining the likely policy rationale behind removing ESRD-only exclusions, or provide a comparison with similar provisions in other states.

Compiled from official sources — confirm details with the bill’s official record.

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