Update on H.R. 8875: Improving Home Dialysis Act of 2026

On May 19, 2026, the Improving Home Dialysis Act of 2026 (H.R. 8875) was introduced in the U.S. House of Representatives and assigned to the House Ways and Means Committee. That Committee’s website has a document posted on June 23, 2026 with a list of organizations that supported this bill and the text they submitted:

• America’s Health Insurance Plans (AHIP)

  “The Improving Home Dialysis Act would help promote competition and patient choice. The pathway to choosing where and how to access dialysis can sometimes be difficult for patients and their loved ones. Not all patients have access to the same choices for their dialysis care, especially underserved populations and those in rural areas. Self-dialysis, including peritoneal dialysis and home hemodialysis, is a safe and effective treatment option for patients with permanent kidney failure, offering logistical, economic, and quality-of-life benefits.” – AHIP

• Alliance for Home Dialysis

  “The Alliance for Home Dialysis thanks Chairman Jason Smith, Representative Carol Miller, and members of the House Ways and Means Committee for continuing their work to support patients with kidney failure and advance policies that empower patients and make home dialysis more accessible.” – Margaret French, Managing Director, Alliance for Home Dialysis

• Boehringer Ingelheim

  “Boehringer commends the Committee’s leadership in advancing policies that expand access to home dialysis, strengthen patient choice, and modernize kidney care delivery. Home-based modalities offer clear benefits to patients, including greater flexibility, improved quality of life, and reduced reliance on facility-based care.” – Boehringer Ingelheim

• Kidney Care Council (KCC)

  “This legislation would establish a Medicare service for Staff-Assisted Home Dialysis Respite Care, allowing qualified healthcare professionals to assist patients in their homes when they are temporarily unable to independently perform the home dialysis procedure. H.R. 8875 would allow patients the opportunity to dialyze using their home dialysis modality even when a temporary barrier to completing the home treatment independently arises.” – KCC

• Kidney Care Partners (KCP)

  “We are encouraged by the Ways & Means Committee’s continued bipartisan focus on policies aimed at expanding access to home dialysis and appreciate the continued leadership of Chairman Jason Smith (R-MO), Ranking Member Richard Neal (D-MA), Rep. Carol Miller (R-WV) and Members of the Committee in advancing policies to strengthen dialysis care options for Medicare beneficiaries. We support and look forward to working collaboratively with lawmakers to ensure the advancement of H.R. 8875, which represents an important milestone in the Committee’s long history of building clinical and social supports for individuals in kidney failure.” – LaVarne Burton, Chairwoman, KCP

• The National Kidney Foundation (NKF)

  “More than a half million Americans rely on dialysis to stay alive, yet many patients who could benefit from home dialysis face significant barriers. The National Kidney Foundation welcomes this important first step towards making this critical treatment option more accessible. We commend Rep. Carol Miller and the Ways and Means Committee for their leadership on this issue. This legislation also builds on the bipartisan foundation laid by the first Trump Administration’s Advancing American Kidney Health Initiative, which set an ambitious national goal to increase home dialysis — a commitment we are glad to see carried forward.” – Jesse Roach, SVP of Government Relations, NKF

• Nonprofit Kidney Care Alliance (NKCA)

  “On behalf of the Nonprofit Kidney Care Alliance (NKCA), we commend the House Committee on Ways & Means for holding a markup on H.R. 8875, The Improving Home Dialysis Act of 2026. This important bill is a vital step forward to removing barriers to home dialysis in our country and is an important piece of the Committee’s ongoing work raising awareness and addressing kidney health policy needs.” – Monica Massaro, Executive Director, NKCA

• Renal Healthcare Association (RHA)

  “On behalf of the Renal Healthcare Association (RHA), I am writing to express my gratitude for the committee’s and Representative Miller’s work on expanding patient access to home dialysis where medically appropriate. H.R. 8875, the ‘Improving Home Dialysis Act of 2026,’ recognizes the additional resources needed to help patients successfully start and maintain home dialysis.” – Bridget Pfaff, President, RHA

• U.S. Renal Care (USRC)

  “On behalf of U.S. Renal Care, I am pleased to see the Committee tackling issues of importance to individuals with end-stage renal disease (ESRD). The hearing held on March 18, 2026, started an important conversation about how to support the expansion of home dialysis and evolve our health care system into one that incentivizes medical innovation for dialysis patients.” – Francine F. Attrill, Vice President, USRC

The Bill’s Current Status

 In a markup session, the Ways and Means Committee passed this bill by a 28 to 13 vote. On May 21, 2026, the Committee ordered that it be considered by the full House and Senate. To have any chance of passage, there would need to be a “companion” bill in the Senate. GovTrack estimates that this bill currently has a 34% chance of being enacted, which is somewhat better than the 1 in 4 chance that most bills have of moving out of Committee. If passed, it would amend the Social Security Act, Title XVIII (Medicare) to allow adjustment to dialysis reimbursement for limited staff-assistance and renal mental health services for home dialysis patients starting on January 1, 2028.

What H.R. 8875 Provides

As passed out of the Ways and Means Committee to the full House of Representatives, this bill would provide:

1. Staff-assisted home dialysis respite care:

• For a temporary period (up to 20 treatments a year) during the first 30 days of home dialysis or anytime a home dialysis patient has a physical limitation to doing dialysis independently.

• To an individual with Medicare on a day when s/he is doing home dialysis.

• When that patient is doing dialysis at home (specifically not in a nursing home).

• When provided by a qualified RN, LPN, certified PC, or other medical professional specified by the Secretary.

• With Medicare reimbursement for a staff-assisted home dialysis session equal to the 2025 payment for a home dialysis training session if the patient lives in a rural area (75% of that amount if not rural).

2. Renal mental health services:

• For up to 4 sessions during the first 60 days of home dialysis on a day the patient is dialyzing at home.

• With a Medicare reimbursement equal to 50% of the 2025 payment for home dialysis training for a rural home dialysis patient (25% of that amount if not rural).

Renal Mental Health Services

Not to go off too far on a tangent, but I was surprised to see that H.R. 8875 proposes additional Medicare reimbursement for mental health services knowing that the ESRD Conditions for Coverage (regulations) requires dialysis facilities to have a master’s prepared social worker who is required to assess all patients’ psychosocial status and provide interventions, including counseling and referrals to help patients “achieve and sustain an appropriate psychosocial status as measured by a standardized mental and physical assessment tool…”

According to a one-pager on the Committee site, the bill’s author, Carol D. Miller (R-WV), understands that dialysis patients have greater anxiety and depression than the general population. She knows that dialysis facilities have qualified social workers on staff, but believes “…this care is not consistently available to home patients.” I am glad that at least one member of Congress recognizes that home dialysis patients have significant mental health needs. I am glad Rep. Miller knows dialysis facilities have qualified social workers. However, I am concerned that she believes dialysis social workers are not consistently addressing home dialysis patients’ mental health needs. If social workers are not meeting home dialysis patients’ mental health needs, why not?

There are challenges to finding a community mental health provider with experience working with dialysis patients, much less those on home dialysis. It’s important for such a provider to understand how the treatment and care needs can contribute to a patient’s physical and mental stressors. Plus, Medicare reimbursement of 25%-50% of the reimbursement for a home training session, could make it harder to find a provider. So, if social workers are not meeting home dialysis patients mental health needs either directly or by referral, ESRD surveyors should be holding them and dialysis facilities accountable. Surveyors should ask the administrator and social worker about caseload and task assignment to determine if staffing and role are appropriate to meet home dialysis patients’ psychosocial and mental health needs as required by regulation. See 42 CFR 494.180(b)(1) and V758 in CMS’ State Operations Manual Appendix H, which includes text from the regulation and interpretive guidance. The tag a surveyor would cite if the facility is out of compliance is V758, which states, “…If the facility “shares” the social worker or dietitian with multiple clinics, or requires professional staff to perform non-clinical tasks, it must not negatively impact the time available to provide the clinical interventions required to achieve the goals identified in the patient’s plan of care. The facility CEO or administrator is responsible to ensure the professional support staff members have sufficient time available in the facility to meet the clinical needs of in-center and home dialysis patients.” I call on facilities and surveyors to assure that home dialysis patients have consistent and sufficient access to their dialysis social worker.

Next Steps

If you support this proposed bill, contact your representative and encourage your senators to bring a companion bill to the Senate. Don’t know who they are or how to reach them? Find Your Members here by typing in your home address. Then:

• If you’re a dialysis professional, write how you think this bill would help more patients choose home dialysis and/or would help your facility retain patients on home dialysis, especially patients new to home dialysis or those who have no one to help with their home dialysis when they have a temporary physical limitation.

• If you’re a home dialysis (PD or home HD) patient or care partner, write how staff-assisted home dialysis could have helped you during the first month of home dialysis or when a physical limitation and inability to do home dialysis required you (or the patient) to do in-center dialysis. Also include how being required to do in-center dialysis affected a job or other key things in life because Medicare doesn’t currently reimburse for staff-assisted home dialysis,

• If you’re an in-center dialysis patient considering home dialysis, write about how you might consider home dialysis if Medicare paid your facility for up to 20 days of staff-assisted home dialysis during your first month of home dialysis. If you have no or no willing care partner, having that respite help could increase your confidence, competence, and comfort and doing dialysis at home could increase the chance you could have a paid or volunteer job, do activities you love, and improve your physical health, mental health, and quality of life.

• If you’re a dialysis social worker, write about your experience working with home dialysis patients, assessing their strengths and challenges, identifying their goals, providing education about treatment options, and counseling them to help them cope with kidney failure and dialysis.

Conclusion

Dialysis patients, home dialysis providers and non-profit organizations have been calling for Medicare coverage of staff-assisted home dialysis for years. In this session of Congress, the Improving Home Dialysis Act of 2026 could pass as currently written, be amended, fail to be brought up for a vote, or not have enough votes to pass. If you want Medicare to cover this service for eligible patients, even temporarily or have ideas for how to improve this proposed legislation without breaking the bank, make your voice heard by contacting your representative and/or senators. It could make all the difference in the world and help more people choose to start and stay on home dialysis.