SB 111
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
Third Reader
Senate Bill 111 (Senator Kramer)
Finance Health and Government Operations
Health Care Facilities – Dialysis Treatment Services – Training (David Selby
Dialysis Parity Act)
This bill prohibits a “health care facility” from providing peritoneal dialysis or
hemodialysis treatment services unless the individual performing the procedure is trained
in the technique being performed. “Health care facility” includes a kidney dialysis center,
a facility operated by the Maryland Department of Health (MDH) or a health officer, and
a health care provider’s office. Each violation of this prohibition is subject to a civil penalty
of up to $5,000. MDH must adopt regulations to carry out the bill. The bill takes effect
July 1, 2022.
Fiscal Summary
State Effect: The bill is not anticipated to materially affect State operations or finances.
Local Effect: None.
Small Business Effect: None.
Analysis
Current Law:
Licensure of Kidney Dialysis Centers in Maryland
MDH’s Office of Health Care Quality (OHCQ) licenses all freestanding kidney dialysis
centers under its regulations regarding freestanding ambulatory care facilities. A “kidney
dialysis center” means a facility that provides hemodialysis or chronic peritoneal dialysis,
but it does not include a center or service owned or operated by a hospital. Under these
regulations, a kidney dialysis center must be in compliance with all applicable federal,
State, and local laws and regulations and must also submit a Medicare certification as a
condition of licensure. The administrator of a kidney dialysis center must ensure that the
center has a quality assurance program. MDH may cite health care facilities and
community-based providers under its existing authority for the failure to appropriately train
their staff to perform a dialysis procedure.
Maryland Commission on Kidney Disease
The Maryland Commission on Kidney Disease promotes quality health care in the field of
nephrology and transplantation by certifying dialysis and transplant centers, receiving and
resolving complaints from interested parties, and setting standards for the practice of
chronic dialysis and transplantation that reflect new and emergent developments. The
commission is charged with adopting physical and medical standards for the operation of
dialysis and transplant centers. Although certification is voluntary, the commission
certifies treatment centers that meet the standards it adopts for providing services to
recipients. The commission inspects certified facilities annually. Treatment centers must
also be licensed by OHCQ in order to treat patients, but this licensure is separate from
certification.
Additional Comments: According to the National Kidney Foundation, a nurse or patient
care technician generally performs dialysis treatments and typically receives in-depth
training prior to performing such treatments.
Additional Information
Prior Introductions: SB 494 of 2020, a similar bill, passed in the Senate and received a
hearing in the House Health and Government Operations Committee, but no further action
was taken.
Designated Cross File: HB 484 (Delegate Cullison) - Health and Government Operations.
Information Source(s): National Kidney Foundation, Maryland Department of Health;
Department of Legislative Services
Fiscal Note History: First Reader - January 15, 2021
rh/jc Third Reader - March 19, 2021
Analysis by: Amberly Holcomb Direct Inquiries to:
(410) 946-5510
(301) 970-5510
SB 111/ Page 2


Statutes affected:
Text - First - Health Care Facilities – Dialysis Treatment Services – Training (David Selby Dialysis Parity Act): 19-114 Health General, 19-150 Health General
Text - Third - Health Care Facilities – Dialysis Treatment Services – Training (David Selby Dialysis Parity Act): 19-114 Health General, 19-150 Health General, 20-2002 Health General, 20-2001 Health General