This bill allows Medicare to cover a special type of dialysis called 'palliative dialysis' for people with kidney failure who choose hospice care. Palliative dialysis is dialysis given for comfort purposes only, not to treat or maintain kidney function—it's meant to help manage symptoms and improve quality of life as someone approaches the end of life.

Right now, Medicare has unclear rules about whether it will pay for dialysis when someone is also receiving hospice care. This bill clarifies that Medicare will cover palliative dialysis services for eligible patients. The key change is that dialysis facilities and hospitals will be paid separately for palliative dialysis—it won't be bundled into the hospice care payment. This means the dialysis provider gets paid directly by Medicare for these services, similar to how they'd be paid for regular dialysis, but with adjustments to account for the different nature of palliative care.

The bill limits coverage to a maximum of 10 dialysis sessions per patient (or the equivalent if someone is doing home dialysis), though the government can reassess this limit starting in 2029 based on how the program is actually being used. Patients will still have to pay their normal Medicare deductibles and coinsurance for these services. The bill also makes clear that if someone with kidney failure chooses hospice for a different reason (not kidney-related), they can still get regular maintenance dialysis covered under normal Medicare rules.