The 1972 amendments, effective July 1, 1973, extended health insurance coverage (R-HI and R-SMI) to persons who have chronic renal disease (CRD) and require regular dialysis or kidney transplantation.

Effective October 1, 1978, amendment to title II and title XVIII of the Social Security Act made significant modifications in the Chronic Renal Disease (CRD) Program, now called the End Stage Renal Disease (ESRD) Program. These modifications are outlined in DI 45001.001 and HI 00801.186f. The most significant modifications involving the issue of continuation or termination of ESRD Medicare coverage was the extension of the period of Medicare coverage from 12 months to 36 months following the month of kidney transplant. In cases of cessation of regular dialysis, Medicare coverage was not changed by the 1978 Amendments; entitlement continues for 12 months following the month dialysis ended.