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Killian Gause

The Biden administration has taken the following executive actions that address healthcare and COVID-19 relevant to the kidney community in its first few days in office:

■ The Executive Order (EO) on Organizing and Mobilizing the United States Government to Provide a Unified and Effective Response to Combat COVID-19 and to Provide United States Leadership on Global Health and Security accelerates manufacturing and delivery of supplies for vaccination, testing, and personal protective equipment, which has been a top policy priority of ASN’s since the beginning of the public health emergency. This EO, along with the EO on the Sustainable Public

The year 2020 was an incredibly difficult one for the world, the nation, and the kidney community. In facing significant and new challenges, the American Society of Nephrology (ASN) shifted policy priorities to reflect the changing environment while still advocating for kidney patients and the kidney care professionals treating them and conducting research on their behalf. Pivoting traditional in-person congressional office visits with the ASN Policy and Advocacy Committee and the ASN Quality Committee to virtual ones, ASN delivered key policy messages to influence both coronavirus infectious disease 2019 (COVID-19) stimulus packages and the annual appropriations process.

After months of

In a rush to complete regulatory activities before both the end of the year and the transition to an incoming Biden-Harris administration, the Centers for Medicare & Medicaid Services (CMS)—as well as other federal agencies—announced several administrative steps and final rules important to both nephrologists and other clinicians.

CMS announced that it is accepting the impact of COVID-19 as a condition for receiving an Extreme and Uncontrollable Circumstances exemption in the Merit-based Incentive Payment System (MIPS). MIPS is the largest quality payment program administered by CMS.

An Extreme and Uncontrollable Circumstances exemption would allow clinicians, groups, and virtual groups to

Mallika Mendu and David White

In September 2020, the Centers for Medicare & Medicaid Services (CMS) and its Innovation Center (CMMI) finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. This model will test changes to care for Americans with kidney disease within a 30%, randomized set of Medicare beneficiaries with ESRD. The stated goals are increasing patient choice, increasing utilization of home dialysis, and providing greater access to transplantation, options for which the American Society of Nephrology (ASN) has long advocated.

The government will use hospital referral regions (HRRs) to randomize participation. Within those selected HRRs, both dialysis units, “facility,” and nephrologists, “managing

ASN needs your help to ensure kidney transplant patients are able to access life-saving immunosuppressive medications.

Congress has introduced the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act (H.R. 5534/S. 3353), bipartisan legislation that would remove Medicare’s three-year limit for coverage of immunosuppressive drugs.

According to a pre-pandemic Department of Health & Human Services report, hundreds of kidney transplant patients lose their transplant due to an inability to afford immunosuppressive medication. This is not only costly to the health of the patient, but also to Medicare as the patient returns to dialysis. A recent analysis by the non-partisan Congressional

David White

Nephrologists will see payment increases in some services starting January 1, 2021, according to the proposed rule on the annual physician fee schedule released last month by the Centers for Medicare & Medicaid Services (CMS). In general, nephrology will see an overall 6% increase with an approximately 30% increase for home dialysis services.

Anupam Agarwal, MD, FASN, ASN President, praised the move by CMS: “Finally, after years of advocacy by ASN, Medicare is supporting nephrologists with rates that better reflect our work. Most importantly, this is a big win for home dialysis, a top priority for ASN.”

Payment and codes

A recent report from the Department of Health and Human Services (HHS) shows the impact the COVID-19 public health emergency has had on the expansion and increased utilization of telehealth. Medicare fee-for-service primary care visits provided through telehealth in April 2020 jumped to 43.5%, compared to far less than 1% in February 2020, before the public health emergency (1).

Kidney News invited Scott Bieber, DO, ASN Quality Committee chair, and Terrence Jay O’Neil, MD, FASN, ASN Quality Committee member, two nephrologists practicing in rural communities, to discuss how their practices are providing kidney care via telehealth and

A robust and diverse group of health professionals and researchers serves as an asset to the nation’s healthcare system, provides a sound foundation of scientific and medical expertise, and ensures the highest quality of patient care.

ASN and its members have long tracked federal policies that impact international medical graduates who are citizens of other nations (non-US IMGs) given their strong representation in the nephrology workforce. In 2017, the US nephrology workforce had the second highest percentage among medical specialties of active physicians who were international medical graduates at 49% (1). Non-US IMGs are necessary to maintain a

In late 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Organ Procurement Organizations (OPOs) Conditions for Coverage. The proposed rule intends to require transparent, verifiable, and uniform metrics by which CMS can evaluate OPO performance. The American Society of Nephrology (ASN) provided comments of support and recommendations for improvement in February 2020.

The proposed rule would replace the existing outcome measures for OPO recertification with two new outcome measures that would be used to assess an OPO’s performance: “donation rate” and “organ transplantation rate,” effective beginning in 2022. The “donation rate” would be measured

ASN has recently advocated for numerous policies that address the current kidney care system as well as the effects of COVID-19 on kidney patients and kidney care professionals.

The COVID-19 pandemic has posed unique challenges for the 37 million Americans affected by kidney disease and the physicians who care for them as parts of the nation transition to various phases of reopening. ASN recently collaborated with the National Kidney Foundation (NKF) on behalf of kidney patients and kidney care professionals in advocacy efforts on two COVID-19 related policies.

Discriminatory Ventilator Policies

COVID-19 has created challenges for states and hospital systems