H.R. 9509: Kidney Disease Education Access Expansion Act of 2026

This bill would expand access to kidney disease education services under Medicare and private health insurance, starting in 2027.

What Medicare coverage would change

Under Medicare, the bill would broaden who can receive kidney disease education. Right now, these services are generally limited to people with stage IV chronic kidney disease who are expected to need dialysis or a kidney transplant. The bill would expand eligibility to include people with:

• hypertension,
• diabetes,
• any stage of chronic kidney disease, or
• other risk factors for kidney disease progression or kidney failure, as determined by the provider.

It would also expand who can provide these services. In addition to certain medical professionals, the bill would allow:

• providers in rural areas,
• clinical social workers,
• registered dietitians or nutrition professionals, and
• other trained individuals, such as community health workers, working under the direction of an approved provider.

The bill would let the education be provided one-on-one or in a group setting, and patients could choose to have a caregiver present.

It would also add to the topics that education may cover. These would include:

• ways to slow kidney function decline,
• caregiver training and support for new transplant recipients,
• basic help for people after a kidney transplant, including post-transplant self-care and follow-up care coordination, and
• other topics the Secretary of Health and Human Services considers important for patient safety and transplant outcomes.

The bill would remove the current cap of six sessions and instead let the Secretary set an appropriate number of sessions based on consultation with patients, caregivers, and qualified providers.

It would also explicitly allow kidney disease education services to be delivered through telehealth, and it would require Medicare to pay 100% of the allowed amount for these services, meaning no patient cost-sharing under the Medicare payment rule described in the bill.

In addition, the bill would add kidney disease screening to certain Medicare preventive visits:

• the initial preventive physical examination, and
• the annual wellness visit.

These screenings could include routine blood and urine testing, as well as other screening tools the Secretary approves, with referrals to kidney disease education services when appropriate.

What private insurance would change

The bill would also add kidney disease education services to the list of preventive services that most private health plans must cover without cost-sharing, similar to other required preventive benefits. This would apply to plan years beginning on or after January 1, 2027.

Study, reporting, and evaluation requirements

The bill would direct the Secretary of Health and Human Services to convene a working group within 180 days of enactment. The group would include education providers, patients and caregivers, technology specialists, learning assessment experts, and CMS representatives.

This group would be tasked with developing ways to measure:

• how well patients understand the education,
• whether it changes behavior, and
• whether it improves health outcomes.

The group would also look at different learning styles and the effects kidney disease may have on thinking and memory, and it would recommend standard measures for judging which education methods work best. It would have to submit a public report to Congress and the Secretary within 18 months after it is formed.

After receiving that report, the Secretary would have two years to create a broader assessment framework for evaluating the effectiveness of kidney disease education services. The bill gives the Secretary flexibility to do this through guidance, regulations, pilot programs, or a phased rollout. The Secretary would be able to use the results to improve the program and could adjust payment rules, coverage rules, or quality measures based on what the data show.

Relevant Companies

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