Medicare now covers comfort dialysis for hospice patients—with a 10-session cap

What it does

This bill allows Medicare to pay for palliative (comfort-focused) dialysis services separately from hospice care for patients with end-stage renal disease who choose hospice. Currently, hospice covers most services in a bundled payment, but this bill carves out dialysis as a separate billable service, capping it at 10 sessions per year initially, with the Secretary of Health and Human Services able to adjust that limit after 2029 based on data and stakeholder feedback.

Why we flagged it

The bill's core function is to expand Medicare coverage for a specific palliative care service (dialysis) for hospice patients, clarifying and enabling concurrent access to both services. It is a targeted healthcare policy change, not a broad reform or carve-out for industry benefit.

What the text implies

• The 10-session annual cap may be insufficient for some patients' comfort needs, potentially forcing difficult end-of-life decisions based on session limits rather than medical necessity.
• The bill delegates significant authority to the Secretary to redefine 'palliative dialysis services' and adjust session limits after 2029, creating regulatory uncertainty for providers and patients.
• Dialysis facilities and hospice providers will need to coordinate billing and care delivery; unclear operational guidance could delay or fragment care for patients.
• The cost-sharing (deductible and coinsurance) provisions that apply to maintenance dialysis also apply here, which may create financial barriers for low-income hospice patients seeking comfort dialysis.

Who it affects

Patients with end-stage renal disease who choose hospice gain access to palliative dialysis to manage symptoms and comfort without being forced to choose between hospice and dialysis. This expands end-of-life care options for a vulnerable population and clarifies Medicare coverage, reducing financial and medical uncertainty at a critical time.

Who stands to gain

• renal dialysis facilities
• hospice providers
• dialysis equipment manufacturers

Named in the bill

Medicare, Social Security Act, Section 1812, Section 1814, Section 1881, HHS Secretary, end-stage renal disease (ESRD), dialysis facilities, hospice programs, Medicare Benefit Policy Manual

Where it stands

2 cosponsors: 1 Democrats, 1 Republicans.

• Apr 20, 2026 — Introduced · Congress.gov: “Introduced in House”
• Apr 20, 2026 — Referred to House Committee on Energy and Commerce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

3 lobbying clients named this bill on 3 disclosure filings across 1 quarter, Jun 2026 to Jun 2026. Those filings disclosed $1,100,000 in lobbying spend. A filing names 5 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 61% of bills with at least one filing.

Mike Kelly, the sponsor, reported $955,974 in PAC receipts in the 2026 cycle. $9,500 of that came from 1 PAC tied to these lobbying clients.

• Davita Inc — $980,000 on 1 filing
• Nonprofit Kidney Care Alliance — $90,000 on 1 filing
• Dialysis Clinic, Inc. — $30,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.