Improving Home Dialysis Act of 2026

This Act may be cited as the Improving Home Dialysis Act of 2026.
Section 1881(b)(9) of the Social Security Act (42 U.S.C. 1395rr(b)(9)) is amended—
in subparagraph (C), by striking and at the end;
by redesignating subparagraph (D) as subparagraph (F);
by inserting after subparagraph (C) the following new subparagraphs:
beginning January 1, 2028, staff-assisted home dialysis respite care furnished to a patient in the place of residence used as such patient’s home (other than a skilled nursing facility or a nursing facility (as defined in section 1919(a)));
beginning January 1, 2028, renal mental health services furnished to a patient in the place of residence used as such patient’s home (other than a skilled nursing facility or a nursing facility (as defined in section 1919(a))); and
by adding at the end the following flush matter:
Section 1881(b)(14) of the Social Security Act (42 U.S.C. 1395rr(b)(14)) is amended—
in subparagraph (D)—
in clause (iii), by striking and at the end;
by redesignating clause (iv) as clause (vi); and
by inserting after clause (iii) the following new clauses:
shall include a payment adjustment for staff-assisted home dialysis respite care (as described in paragraph (9)(D)) in accordance with subparagraph (J);
shall include a payment adjustment for renal mental health services (as described in paragraph (9)(E)) in accordance with subparagraph (K); and
by adding at the end the following new subparagraphs:
For purposes of subparagraph (D)(iv), subject to clause (ii), a payment adjustment shall be made for each session of staff-assisted home dialysis respite care (as described in paragraph (9)(D)) furnished during a year equal to the amount of the add-on per treatment adjustment for home and self-dialysis training furnished in 2025 (or, in the case of such care that is not furnished in a rural area (as defined for purposes of such subparagraph), 75 percent of such amount).
In no case may a payment adjustment under subparagraph (D)(iv) be made for staff-assisted home dialysis respite care furnished to an individual—
for more than 20 sessions in a calendar year; or
on a day when such individual was not dialyzing at home.
Any payment adjustment under subparagraph (D)(iv) for staff-assisted home dialysis respite care shall not be made in a budget neutral manner.
For purposes of subparagraph (D)(v), subject to clause (ii), a payment adjustment shall be made for each session of renal mental health services (as described in paragraph (9)(E)) furnished during a year equal to 50 percent (or 25 percent, in the case of such services that are not furnished in a rural area (as defined for purposes of subparagraph (D))) of the amount of the add-on per treatment adjustment for home and self-dialysis training furnished in 2025.
In no case may a payment adjustment under subparagraph (D)(v) be made for renal mental health services furnished to an individual—
for more than 4 sessions occurring during the 60-day period beginning on the first day that the individual initiates home dialysis; or
on a day when such individual was not dialyzing at home.
Any payment adjustment under subparagraph (D)(v) for renal mental health services shall not be made in a budget neutral manner.
Section 1834(r)(1) of the Social Security Act (42 U.S.C. 1395m(r)(1)) is amended by striking subparagraph (D)(iv)(II) and inserting subparagraph (D)(vi)(II).