People with kidney diseases experience higher risk during health crises like the COVID-19 pandemic. To address the essential needs of this high-risk population, advocates from the American Society of Nephrology (ASN) and the American Association of Kidney Patients (AAKP) met with representatives, senators, and their respective staffs April 1, 2020 as part of the annual Kidney Health Advocacy Day (KHAD).
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.
After much dialogue with the American Society of Nephrology (ASN) and other members of the kidney community, the Centers for Medicare and Medicaid Services (CMS) today clarified its guidance on deferring nonessential surgical procedures during the COVID-19 Public Health Emergency. The clarification clearly identifies Arteriovenous Fistulas, Arteriovenous Grafts, Peritoneal Dialysis Catheters, and intravenous catheters as planned procedures that are essential for establishing the vascular access that “is crucial for End Stage Renal Disease (ESRD) patients to receive their life-sustaining dialysis treatments.” Since the issuance of the original guidance, many ASN members have expressed their serious concerns that these procedures were being grouped with elective surgeries and, subsequently, being denied. Go to the ASN COVID-19 Response page for more information.
The long push for payment models to cross the silos of kidney care – chronic kidney disease (CKD), kidney failure and dialysis, and kidney transplant – continues with newly announced modifications to the implementation timeline of the Kidney Care Choices (KCC) Model, often referred to as the voluntary model. The Center for Medicare and Medicaid Innovation (CMMI), which creates models and created the ESCOs, has extended the implementation period from March 31, 2021, until December 31, 2021. The effective performance year that was scheduled to begin April 1, 2021 will now begin January 1, 2022.
The American Society of Nephrology (ASN) provided comments and critique of the proposed rule on Medicare Advantage (MA) for 2021 and 2022 on April 6, 2020. In 2021, by law, MA plans will be open to patients with kidney failure as opposed to those who were already enrolled in MA plans before advancing to kidney failure and remain enrolled after kidney failure.
After much urging from the American Society of Nephrology (ASN) and other members of the kidney community, the Centers for Medicare and Medicaid Services (CMS) issued a sweeping interim final rule on March 30 that provides multiple waivers the community requested to provide greater flexibility during the COVID-19 public health emergency (PHE). Of particular importance for ASN members, the rule greatly expands the use of telehealth in providing care to kidney patients – especially those with kidney failure receiving dialysis – for the duration of the PHE. CMS clarified that all evaluations of dialysis patients covered under the ESRD monthly capitated payment (MCP) may now be conducted via telehealth to protect those vulnerable patients and prevent further spread of the novel coronavirus 2019.
People who receive dialysis at home, and the nephrologists who care for them, need additional options in order to receive care, and reduce risk of infection, during the COVID-19 pandemic. Thanks to the work of the American Society of Nephrology (ASN) and other members of the kidney community, important actions to protect these vulnerable patients have been enacted into law.
On Friday, March 27, 2020, the CARES Act* was signed into law. Section 3705 of this act eliminates a statutory requirement for a nephrologist to conduct a face-to-face evaluation of a home dialysis patient, allowing the Department of Health and Human Services (HHS) to issue emergency waivers so the entire visit can be conducted via telehealth. The emergency waiver authority will remain in place during the COVID-19 emergency period.