Medicare expands home dialysis support—but only for the first 60 days
H.R. 8875 — Improving Home Dialysis Act of 2026 · Filed by Carol Miller (R-WV) · 2 cosponsors · Introduced May 19, 2026 · Reported out
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What it does
This bill expands Medicare coverage for home dialysis patients by adding two new support services: staff-assisted respite care (allowing a nurse or technician to take over dialysis temporarily during the first 30 days of home treatment) and renal mental health counseling (up to 4 sessions in the first 60 days). Medicare will pay providers a per-session add-on fee for these services, starting January 1, 2028, with higher payments in rural areas and no requirement to offset costs elsewhere in the dialysis payment system.
Why we flagged it
The bill's core mechanism is straightforward: it adds two new reimbursable services to Medicare's home dialysis benefit and establishes payment rates. This is a standard coverage-expansion bill, not a rider or hidden carve-out.
What the text implies
- Non-budget-neutral payment means these services will increase total Medicare dialysis spending without offsetting reductions elsewhere, potentially raising program costs by tens of millions annually depending on uptake.
- Rural payment premiums (100% for respite, 75% for mental health vs. lower urban rates) may incentivize providers to concentrate services in rural areas, affecting access patterns.
The full analysis lists 5 implications of this text.
Who stands to gain
dialysis service providers (DaVita, Fresenius Medical Care, Renal Care Group); mental health professionals and counselors serving dialysis patients; nursing and technician staffing agencies serving home dialysis programs