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HR 8376

Concurrent Care for Comfort Act

119th Congress Introduced by Suzan DelBene and 2 co-sponsors

Establishes separate Medicare coverage and payment for palliative dialysis during hospice, with a defined annual payment method, a capped number of sessions, and rulemaking.

Introduced in House
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WeVote Research Nonpartisan
Bill Summary · HR 8376

Overview

  • Bill: HR 8376, the Concurrent Care for Comfort Act
  • Session: 119th Congress
  • Purpose: Amend the Social Security Act to clarify Medicare coverage and separate payment for palliative dialysis services for individuals electing hospice care, while ensuring concurrent palliative care (dialysis) and hospice services are covered and paid distinctly. The bill also sets a payment methodology and a limit on the number of palliative dialysis sessions, with potential annual adjustments.

What the bill aims to do

  • Confirm that palliative dialysis services can be covered under Medicare for individuals who elect hospice care, alongside standard hospice benefits.
  • Clarify that palliative dialysis furnished by renal dialysis facilities or providers of services to hospice-eligible individuals is part of the coverage under the Medicare program.
  • Establish a separate payment stream for palliative dialysis services, distinct from the standard hospice care payment bundle.

Key provisions and changes

  1. Coverage clarification

    • Amends Section 1812(d)(2)(A) to insert palliative dialysis services (as defined in Section 1881(b)(15)(E)) furnished to a palliative dialysis eligible individual, ensuring these services are covered when the individual elects hospice care (if not an employee of the hospice program).

  2. Separate payment for palliative dialysis

    • Adds a new paragraph to Section 1814(i) clarifying that palliative dialysis services furnished to a palliative dialysis eligible individual during a hospice election period will be billed and paid under Section 1881(b)(15) (i.e., under the separate payment framework for palliative dialysis).

  3. Payment methodology for palliative dialysis

    • Creates a new subsection (15) in Section 1881(b) to govern payment for palliative dialysis services:
      • Annual methodology: For 2026 and each subsequent year, the Secretary must establish a payment methodology for palliative dialysis services furnished to hospice-election individuals (in facilities or at home), with rulemaking.
      • Considerations: The Secretary should consider using payment amounts similar to those under the renal dialysis system for comparable services and assess resources needed to furnish these services, applying appropriate adjustments.
      • Limit on sessions: Generally, payment may not cover more than ten palliative dialysis sessions per eligible individual. For home dialysis (including peritoneal), days are converted to hemodialysis-equivalent sessions using the Medicare Benefit Policy Manual methodology.
      • Potential adjustment: Starting in 2029, the Secretary may assess the appropriateness of the 10-session limit and potentially apply a different limit, based on data and stakeholder feedback, and, if changed, apply the new limit by treating the new number as the reference for the limit.
      • Cost-sharing: Deductibles and coinsurance under the Medicare program would apply to palliative dialysis services per the standard cost-sharing for kidney dialysis services.
      • Defined terms: Provides definitions for “palliative dialysis services” and “palliative dialysis eligible individual,” clarifying that palliative dialysis services are for palliative care (not treatment or maintenance) per a physician-certified plan of care, potentially including non-emergency transportation among other related services.
      • Clarification: The changes do not affect coverage or payment for renal dialysis services for individuals with ESRD who elect hospice care for non-ESRD primary conditions.

Who would be affected

  • Palliative dialysis eligible individuals with end-stage renal disease (ESRD) who elect hospice care under 1812(d)(1).
  • Renal dialysis facilities and providers of services to hospice-eligible individuals, which would bill and be paid separately for palliative dialysis services, outside the standard hospice care payment bundle.
  • Medicare program administration, specifically the Centers for Medicare & Medicaid Services (CMS) with respect to payment methodologies, rulemaking, and annual adjustments.

Procedural and timeline notes

  • Introduction date: April 20, 2026.
  • Referral: House Ways and Means Committee and House Energy and Commerce (for provisions within respective jurisdictions).
  • Effective timelines:
    • Establishment of payment methodology begins for 2026 and forward, with ongoing rulemaking.
    • A potential reassessment and possible adjustment of the 10-session cap would occur beginning in 2029, based on data and stakeholder feedback, withSecretary authority to modify the limit accordingly.
  • The bill includes explicit definitions and cross-references to sections of the Social Security Act (sections 1812, 1814, and 1881) to integrate with existing Medicare structures.

Practical impact and considerations

  • For eligible patients, there could be clearer access to concurrent hospice and palliative dialysis services, with distinct payment paths ensuring providers can be compensated for palliative dialysis delivered during hospice enrollment.
  • The 10-session limit (subject to potential adjustments) may shape how long palliative dialysis can be billed under this new framework, potentially influencing care planning.
  • The bill emphasizes aligning palliative dialysis payments with existing dialysis payment systems to maintain consistency in reimbursement and cost-sharing for patients.
  • Stakeholders (providers, patients, and hospice programs) would participate in rulemaking to refine payment amounts and any adjustments to session limits.

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

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