In the wake of the Coronavirus Disease-2019 (COVID-19) Pandemic, the Medicare program is expanding telehealth coverage enabling clinicians to provide a wider range of health care services to their patients without those patients having to travel to a health care facility thereby reducing exposure. The American Society of Nephrology (ASN) strongly supports this bold move. Retroactive to March 6, 2020, Medicare, under waiver authority, will temporarily allow and pay clinicians to provide telehealth services for beneficiaries residing across the entire country.
A new CPT® code, 87635, has been released for immediate use for novel coronavirus testing offered by hospitals, health systems, and laboratories in the United States. The code became effective Friday, March 13, 2020, for reporting of novel coronavirus tests across the entire healthcare system. Because of the immediate release and use of the code, clinicians will need to manually upload this code descriptor into their electronic health record (EHR) system. This CPT code will arrive as part of the complete CPT code set in the data file for 2021 later this year in the Microbiology subsection of the Pathology and Laboratory section.
On February 27, Senators Bill Cassidy, M.D. (R-LA) and Dick Durbin (D-IL) introduced legislation to extend Medicare coverage of immunosuppressive drugs for kidney transplant patients. A top priority for ASN, the common-sense legislation would extend Medicare coverage of immunosuppressive medications for kidney transplant patients beyond the current 36-month limitation, ensuring that kidney transplant patients do not face losing their transplant due to an inability to afford their medications. “Our bill ensures that kidney transplant patients can afford the medication they need to survive and won’t have to skip or ration doses,” said Durbin. “Extending this coverage under Medicare is bipartisan and commonsense, and I urge my Senate colleagues to support this legislation.”
The Executive Order on Advancing American Kidney Health (Section 8) directed the Secretary of Health and Human Services (HHS) to propose a regulation to remove financial barriers to living organ donation essentially:
ASN supported the proposed rule on Removing Financial Disincentives to Living Organ Donation issued by Health Resources and Services Administration (HRSA) of HHS and recommended further changes in its comment letter to the agency February 18, 2020.
NIDDK is establishing a nominal payline for new (Type 1) and renewal or competing continuation (Type 2) R01 applications of 16th percentile in FY 2020, which is higher than the 13th percentile in FY 2019.
The American Society of Nephrology has developed and released the Kidney Care First (KCF) Model Calculator for nephrologists and nephrology practices to help them evaluate how they might perform in the voluntary payment program. The calculator is a guide only and does not calculate every variable that a practice might face; however, it is designed to examine the difference in nephrology practice reimbursement in the status quo versus the KCF Option in the Kidney Care Choices (KCC) Model. This device is intended for practices already considering the KCF Option.
The American Society of Nephrology (ASN) and National Kidney Foundation (NKF) are hosting a webinar on the key features of the Comprehensive Kidney Care Contracting Options of the Kidney Care Choices (KCC) payment model on Monday, January 13, 2020, from 2:00-4:30 p.m. ET.
The Centers for Medicare & Medicaid Services created the voluntary KCC payment model as a part of the administration's Advancing American Kidney Health initiative.
In this webinar, examine key features of the new model and discover potential implications for your practice with real-life scenarios. Review crucial elements such as eligibility and the finance and payment structure.
Zachary Kribs is the ASN Government Affairs Specialist
The House Energy and Commerce Committee held a hearing on Wednesday, January 8th, on the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019, advancing a long-standing legislative priority of the American Society of Nephrology.
The legislation, introduced in late December by Representative Ron Kind and Representative Michael Burgess, along with three other original sponsors, would allow Medicare to pay for immunosuppressive drugs for kidney transplant patients for the lifetime of the organ transplant. Medicare currently reimburses immunosuppressive drug coverage for only 36 months, leaving many individuals who cannot afford other coverage at risk of losing the transplanted kidney. The legislation is a top priority of ASN and has been the focus of several advocacy initiatives, including Kidney Community Advocacy Day convened by ASN in November 2019.
After two months of ASN advocacy, led by the ASN Quality Committee, the Centers for Medicare and Medicaid Services (CMS) today, January 2, 2020, announced adjustments to the proposed Kidney Care Choices (KCC) Model’s basic design. The changes were originally called for by the ASN Quality Committee – just after the model’s unveiling – and were intended to correct a design flaw that made it impossible for many nephrology practices in multi-specialty practices to participate.
The American Society of Nephrology (ASN) Department of Policy and Government Affairs team has received numerous questions from interested members on the proposed payment models arising from the Executive Order on Advancing American Kidney Health, the ESRD Treatment Choices (ETC) model and the and Kidney Care Choices (KCC) model. This Kidney News Online series aims to share these questions and answers with the broader ASN membership. Please also see parts 1 and 2 of this series for more background information.