Improving Home Dialysis Act of 2026
Sponsored By: Representative Miller, Carol D. [R-WV-1]
Introduced
Summary
Adds two Medicare-covered home dialysis services: staff-assisted respite care and renal mental health services. The bill defines who can provide them, sets session limits, and creates per-session payment add-ons that take effect January 1, 2028.
Show full summary
- Home dialysis patients and families gain access to staff-assisted home dialysis respite care and renal mental health support delivered at home, not in nursing facilities. Respite care is capped at 20 sessions per calendar year and mental health services are capped at 4 sessions in the 60-day start period.
- Providers must meet specified competency and training standards. "Qualified personnel" for respite include registered nurses, licensed practical nurses, certified patient care technicians, or others the Secretary specifies, and mental health providers must meet the standard in 42 CFR 494.140(d).
- Medicare payment changes add per-session adjustments tied to the 2025 home and self-dialysis training add-on. Respite pay equals the 2025 add-on with a rural adjustment to 75 percent, and renal mental health pay equals 50 percent of the 2025 add-on or 25 percent outside rural areas. These payment adjustments are explicitly not budget neutral.
*Because the payment adjustments are specified as not budget neutral, the bill increases federal Medicare spending.*
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
More home dialysis respite help
If enacted, Medicare would cover staff‑assisted home dialysis respite care at your home starting January 1, 2028. It would apply during the 30‑day period after you start home dialysis and earlier if a physical limitation temporarily prevents you from dialyzing. Qualified personnel would include registered nurses, licensed practical nurses, certified patient care technicians, or other trained medical staff the Secretary specifies. Medicare would pay a per‑session add‑on tied to the 2025 home‑dialysis training add‑on: 100% in rural areas and 75% outside rural areas. Payments would be capped at 20 sessions per calendar year and would not pay for days you did not dialyze at home. These add‑on payments would not be budget‑neutral.
Home dialysis mental health visits
If enacted, Medicare would cover renal mental health services at your home starting January 1, 2028. Services must be given during the 60‑day period after you start home dialysis. They must be furnished by a clinician who meets Medicare's home‑dialysis provider standard (per 42 C.F.R. 494.140(d) or a successor rule). For each qualifying session, Medicare would pay a per‑session add‑on equal to 50% of the 2025 home‑dialysis training add‑on in rural areas and 25% outside rural areas. Payments would be limited to 4 sessions during the 60‑day initiation period and would not pay for days you did not dialyze at home. These add‑on payments would not be budget‑neutral.
Sponsors & CoSponsors
Sponsor
Miller, Carol D. [R-WV-1]
WV • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov