; and (D) by adding at the end the following new subparagraph: (B) For purposes of subparagraph (A)(ii), the following shall apply: (i) The monthly fee or other basis of payment described in such subparagraph shall allow for a patient-specific waiver process to allow a physician, clinical nurse specialist, nurse practitioner, or physician’s assistant to request a waiver under this title of face-to-face visit requirements for home dialysis furnished to individuals determined to have end stage renal disease. (ii) Any request under clause (i) shall include documentation by the physician or practitioner involved that supports active and adequate care of such individual receiving home dialysis. (iii) Any patient-specific waiver under clause (i) that is granted shall remain effective until such date that the Secretary, including through contractor under this title, requests that additional information or a new waiver application be filed. (iv) All individuals determined to have end stage renal disease receiving home dialysis shall receive a face-to-face examination at least once every three consecutive months and, in the intervening months, shall receive a monthly clinical assessment which may be furnished, if the patient so chooses, via remote monitoring by a physician, clinical nurse specialist, nurse practitioner, or physician’s assistant. . (2) Conforming amendment Section 1881(b)(1) of such Act ( 42 U.S.C. 1395rr(b)(1) ) is amended by striking paragraph (3)(A) and inserting paragraph (3)(A)(i) . (3) Effective date The amendments made by this subsection shall apply with respect to the monthly fee or other basis of payment for home dialysis services furnished on or after January 1, 2018. (f) Appropriate valuation of remote diagnostic test services Section 1848(c)(2) of the Social Security Act ( 42 U.S.C. 1395w–4(c)(2) ) is amended by adding at the end the following new subparagraph: (P) Adjustments for remote diagnostic tests In determining practice expense relative value units for diagnostic tests described in