Restore Protections for Dialysis Patients Act (H.R. 2199)

Original title: Restore Protections for Dialysis Patients Act

March 18, 2025

Medicare Health Insurance Dialysis ESRD Healthcare Policy

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Where This Stands

Introduced

Committee

Floor Vote

Passed

Signed

Currently in_committee. The next step in the legislative lifecycle is Floor Vote.

Last action

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.Mar 18, 2025

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

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The Frame

What this does

This bill would legally prohibit private health insurance plans from offering inferior coverage to patients with kidney failure compared to other enrollees, ensuring private plans remain the primary payer for these services.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Patients with End-Stage Renal Disease (ESRD)

The bill prohibits health plans from providing them with different benefits or coverage limitations compared to other plan members.

Group health insurance plans

Plans must ensure their benefit structures do not discriminate against or disparately impact ESRD patients.

Medicare program

The bill aims to prevent the shifting of primary care costs for ESRD patients from private plans to Medicare.

What changed

Current stage: in_committee.

What's next

Floor Vote.

Summary

This bill aims to prevent private health insurance plans from discriminating against patients with . It clarifies that insurance plans cannot limit coverage for dialysis services or shift the primary cost of care for these patients onto Medicare.

Key Facts

Prohibits group health plans from differentiating benefits between individuals with ESRD and other individuals.
Bans health plans from applying benefit limitations that disparately affect individuals with ESRD.
Prevents health insurance plans from shifting the primary cost of ESRD care to the Medicare program.
Explicitly states that plans are not required to include specific renal dialysis providers or a specific number of providers in their networks.
Amends Section 1862(b)(1)(C) of the Social Security Act.
Requires the Secretary of Health and Human Services to enforce these provisions consistent with existing federal regulations (42 CFR part 411).

Frequently Asked Questions

Does this bill force insurance companies to include every dialysis clinic in their network?

No. The bill explicitly states that it does not change a plan's ability to limit which renal dialysis providers it includes in its network.

What is the main goal of this legislation?

To ensure that private health insurance plans cover dialysis patients fairly and do not shift the financial burden of their care onto Medicare.

Why It Matters

News Coverage

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Discoveries

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift100% confidence

Clarification of Network Autonomy

The bill includes a specific carve-out to ensure that while benefit discrimination is prohibited, insurance plans retain their existing rights to curate their provider networks.

H.R. 2199