Chronic Kidney Disease Improvement in Research and Treatment Act of 2017 (H.R. 2644)

The Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 2644) is designed to protect the delivery of high-quality care for patients with kidney disease. Representatives Tom Marino (R-PA), John Lewis (D-GA), and Peter Roskam (R-IL) introduced the bill in the U.S. House of Representatives supporting improvements in the research and treatment of chronic kidney disease. A Senate companion bill is expected to be introduced shortly . H.R. 2644 would benefit more than 645,600 Americans living with kidney failure. Specifically, the legislation would:

Improve Quality of Care

Through more research and evaluations, H.R. 2644 can improve the quality of care, and therefore quality of life, for those living with chronic kidney disease. This can be achieved through legislation in four ways:

  1. Identifying Barriers in Medicare Payment. By requiring that the Secretary of Health and Human Services (HHS) send a report to Congress on barriers in the Medicare payment system that beneficiaries needing kidney transplants or post-transplant care may face, problems with the payment system will be better understood and solved. The report would also include a study on the best way to increase deceased and living organ donations.
  2. Evaluating the End-Stage Renal Disease (ESRD) Payment System. The legislation would require the National Academy of Science to evaluate Medicare’s current ESRD payment system and its ability to adapt new technologies, and suggest how to make the system more adaptable to those technologies to enhance care for patients with ESRD.
  3. Understanding Palliative Care Usage for ESRD. This legislation would require a report from the Government Accountability Office about how palliative care is utilized for people living with ESRD and would help formulate a better understanding of its effects on patients’ quality of life and treatment outcomes.
  4. Kidney Disease in Minority Populations. HHS would be required to send a report to Congress about the factors affecting kidney disease and failure in minority populations.

Empower the Patient

All Medicare beneficiaries living with kidney failure deserve access to treatment options and should be able to keep their existing insurance after being diagnosed with kidney failure. This legislation can help improve beneficiaries with ESRD’s control over their quality and access to care through:

  1. Earlier Access to Care. The 21st Century Cures Act states that Medicare beneficiaries with ESRD can enroll in a Medicare Advantage plan and the care coordination that plan offers starting in 2021. This section would allow patients to access this a year sooner, starting in 2020. It would also move up the 21st Century Cures Act’s MedPAC report on risk adjustment by one year, giving MedPAC until July 1, 2019. Lastly, it would permanently reauthorize the Chronic Special Needs Plan for ESRD, allowing protection and improved care coordination for patients with kidney failure.
  2. Medigap Acess for All ESRD Beneficiaries. Medigap plans help Medicare beneficiaries cover the costs of Medicare services, but are only guaranteed to those over the age of 65. This leaves younger ESRD patients under extreme financial strain. This section calls for guaranteed access to Medigap policies for all ESRD Medicare beneficiaries, regardless of age, so ESRD patients can better afford their care.
  3. Access to Home Dialysis Treatment. This would allow both dialysis facilities and homes to be approved as sites for telemedicine for home dialysis.

Additionally, this bill would allow patients to keep their private healthcare for an additional 12 months, increasing their access to commercial insurance from 30 months to 42.

Improve Care Outcomes

  1. Stabilizing the Dialysis Infrastructure. This bill requires the HHS to correct problems within the ESRD Prospective Payment System (PPS) to increase fairer reimbursement for the costs of providing dialysis care.
  2. Fixing Inconsistencies. Current quality programs for kidney disease are riddled with inconsistencies that provide no benefits for patients, simply increased costs. This section requires more transparency in the process of adopting new measures to ensure a focus on the most important parts of dialysis care in order to improve the quality of patient care outcomes.
  3. More Access for Providers. This bill would give dialysis facilities more access to the Medicare Kidney Disease Education benefit, allowing them to use national accrediting bodies to certify that they meet participation guidelines.The bill would also give nephrology health professionals in underserved areas the right to participate in the National Health Services Corp loan forgiveness program.

Learn more about H.R. 2644:

Reference Documents:

Policy Documents


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