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

This section expands Medicare coverage of kidney disease education services. It broadens eligibility to individuals with hypertension, diabetes, any stage of chronic kidney disease, or other risk factors; permits services in group settings and with caregivers present; adds topics such as slowing kidney decline and post-transplant transition assistance; allows additional providers including physician assistants, nurse practitioners, clinical social workers, dietitians, and community health workers; removes the six-session limit; adds kidney disease screening to the initial preventive physical exam and annual wellness visit; authorizes telehealth delivery; and sets payment at 100 percent of the lesser of the actual charge or the amount under the physician fee schedule. The changes apply to services furnished on or after January 1, 2027.

This section directs the Secretary of Health and Human Services to convene a working group within 180 days of enactment, composed of kidney disease education providers, patients and caregivers, technology and learning specialists, and CMS representatives. The group must develop evidence-based methodologies to assess patient comprehension, behavior change, and clinical outcomes from Medicare kidney disease education services under section 1861(ggg), accounting for diverse learning styles and cognitive impacts, and submit recommendations to the Secretary and Congress within 18 months. The Secretary must then establish and implement a comprehensive assessment framework within 2 years to set metrics, data requirements, reporting, and quality improvements, with authority to adjust payment policies and coverage criteria.

This section requires health insurance issuers to cover kidney disease education services, as defined under Medicare, as a preventive service without cost-sharing for plan years beginning on or after January 1, 2027.