Kidney Community Lauds Bi-Partisan, Bicameral Legislation to Improve Care Coordination, Expand Choice, and Enhance Research for Millions with Kidney Disease, Kidney Failure

February 27, 2015

Complementary bills introduced by Senators Ben Cardin, Mike Crapo and Bill Nelson, Representatives Tom Marino, John Lewis and Peter Roskam, would improve lives of kidney patients

WASHINGTON, DC – Kidney Care Partners (KCP) today praised the bicameral introduction of “The Chronic Kidney Disease Improvement in Research and Treatment Act” (H.R. 1130, S. 598), a bipartisan bill that elevates care, expands access, and promotes research to benefit more than 636,000 Americans living with kidney failure, which is known as end-stage renal disease (ESRD). KCP is a broad-based coalition of patient advocates, clinicians, care professionals, dialysis providers, researchers and manufacturers working together to improve quality of care for individuals with chronic kidney disease (CKD) and ESRD.

Currently, 31 million Americans have some form of kidney disease and are at risk of developing kidney failure absent some form of disease management education or preventive care. Each year, more than 100,000 Americans are diagnosed with ESRD – the final stage of CKD – and therefore require a kidney transplant or dialysis. Due to the limited number of kidneys available for transplantation, 430,000 Americans now rely on life-sustaining dialysis care to survive. In general, patients must undergo dialysis three times a week for several hours per treatment. Under current law, dialysis treatments are covered by the Medicare program, regardless of the individual’s age.

Advocates have long stressed that federal policies are needed to provide patient choice and to ensure access to life-sustaining dialysis, to increase research into CKD, and to create stability in Medicare’s crucial ESRD program. Ultimately, the legislation introduced by Representatives Tom Marino (R-PA), John Lewis (D-GA) and Peter Roskam (R-IL) in the House and Senators Ben Cardin (D-MD), Mike Crapo (R-ID) and Bill Nelson (D-FL) in the Senate would improve patient outcomes through care coordination, expand access to traditionally underserved patient populations, and set the U.S. on the path towards a cure through efficiently managed and coordinated biomedical research.

“This bill is absolutely vital as it provides a clear blueprint for the future of the ESRD program” said Dr. Ed Jones, Chairman of Kidney Care Partners and a practicing nephrologist. “By supporting care coordination, greater patient choice, coordinated research programs, and economic stability, this legislation would strengthen the delivery of care for millions of Americans living with kidney disease.”

Specifically, The Chronic Kidney Disease Improvement in Research and Treatment Act would:

(1) Improve the coordination of care: The legislation would expand care options for patients by, among other things, allowing individuals diagnosed with kidney failure to enroll in the Medicare Advantage program. Under current law, individuals who develop kidney failure are not permitted to enroll in Medicare Advantage (MA) plans despite the Medicare Payment Advisory Commission’s recommendation to eliminate the restriction in order to provide ESRD beneficiaries with the same freedom of choice and access to improved coordinated services as other Medicare-enrolled individuals. Therefore, the legislation would allow ESRD patients to enroll in – and reap the benefits of – MA plans. The bill also would reauthorize on a permanent basis the Special Needs Plan (SNP) for patients with kidney failure who need additional care and attention, as well as extend the length of time beneficiaries may choose to maintain their existing insurance coverage. Importantly, the legislation looks to the future by establishing a voluntary coordinated care program. The coordinated care program would allow physicians and dialysis facilities to work together to improve the coordination of care and reduce costly hospitalizations and rehospitalizations.

(2) Promote patient access and choice: The legislation would expand patient access to kidney disease education programs and home dialysis treatment options through telemedicine, as well as create incentives for nephrologists and other dialysis health care professionals to work in underserved rural or urban areas. The bills also would establish renal dialysis facilities as a cost-effective alternative to hospital outpatient departments for individuals diagnosed with acute kidney injury.

(3) Expand research and enhance coordination: The legislation would identify gaps in research and improve the coordination of federal research efforts. Specifically, the bills would require the GAO to assess the adequacy of federal funding for CKD research relative to the expenditures for CKD care and identify gaps in research. Additionally, the bills would require improved coordination among the various federal agencies conducting CKD research by requiring the development of a strategic plan. Third, the bills would require the Secretary to conduct a study to better understand the progression of kidney disease and treatment of kidney failure in minority populations.

“The kidney community applauds Representatives Marino, Lewis and Roskam as well as Senators Cardin, Crapo and Nelson for their long-time leadership and ongoing efforts to protect this important and vulnerable patient population, and we look forward to working with lawmakers to advance legislation that will improve patient choice and outcomes,” added Dr. Jones. “The Chronic Kidney Disease Improvement in Research and Treatment Act ensures that individuals with kidney disease, have the tools, resources, and care they need to live their lives to the fullest today and into the future.”