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Recently, there have been some very troubling developments involving the Medicare Administrative Contractors – the MACs – that has ASN and other members of the kidney community highly concerned. The MACs, within a short window of time, have announced plans to limit reimbursement for dialysis that occurs more than three times per week exclusively to patients that meet specific acute conditions. The conditions have been outlined in a draft Local Coverage Determination (LCD). These draft LCDs propose that any claim linked to a Plan of Care that includes dialysis treatments occurring more than three per week—for any chronic condition or acute condition not included on the list—will be denied.
More than 20 million Americans have kidney diseases: does the level of funding reflect that public health burden?
On January 18, 2017, the US Government Accountability Office (GAO) released a report entitled National Institutes of Health: Kidney Disease Research Funding and Priority Setting.
Telehealth Waiver
New coverage for telehealth services is on the way for Comprehensive ESRD Care Models, ESCOs, and the patients they serve. The Centers for Medicare and Medicaid Services (CMS) have added a telehealth waiver for their use effective Oct. 1, 2018.
The American Society of Nephrology (ASN) and the Alliance for Home Dialysis have been discussing the need for this waiver with the Centers for Medicare and Medicaid Innovation (CMMI) for over a year. As reported in Kidney News Online earlier this year, ASN and members of the Alliance have been advocating for a broader array of telehealth services for patients with kidney failure to be covered by Medicare for several years now – both on Capitol Hill and with CMS.
The Trump administration unveiled a proposed FY 2018 budget on Tuesday, May 23, that would cut funding for the National Institutes of Health (NIH) by $7 billion, about a 23 percent reduction from current levels. In a statement from American Society of Nephrology (ASN) President Eleanor D. Lederer, MD, FASN, the society denounced the budget and maintained that NIH funding cuts of the level proposed could disrupt medical research, impede the development of innovative treatments for the 40 million Americans living with kidney diseases, and ultimately costs more money for the treatment of kidney diseases and failure.
May is shaping up to be a critical month for the fate of President Donald Trump’s second executive order on immigration that temporarily bans travel from six Muslim-majority countries.
American Society of Nephrology (ASN) is concerned about the impact of the travel bans on the free flow of science and ideas across borders. In a statement in January 2017, ASN President Eleanor D. Lederer, MD, FASN, was quoted as saying “Kidney diseases do not differentiate among race, religion, or geographic borders. As such, the American Society of Nephrology (ASN) is deeply concerned that President Trump’s recent Executive Order on Immigration will disrupt the society’s mission and have a damaging long-term effect on the fight to prevent, treat, and cure kidney diseases across the globe.”
The Quality Payment Program Hardship Exception Application for the 2017 transition year is now available on the Quality Payment Program website .
After two years of diligent efforts by the American Society of Nephrology (ASN) and other members of the Alliance for Home Dialysis, the provisions of the CHRONIC Care Act were signed into law after being included in the two-year budget agreement passed in February. The CHRONIC provisions authorize, among other items, a home dialysis patient’s monthly clinical visits to be conducted via telehealth with the home as an originating site. ASN and others supported the inclusion of telemedicine provisions in the recent congressional budget deal to pave the way for greater use of the technology and to boost access to care while reducing costs.
While the legislative success was widely applauded by ASN and other members of the Kidney Community, that was just part of the story. The other part has been playing out on the regulatory side in a choreographed dance between ASN and peer societies on one side and with the Centers for Medicare and Medicaid Services (CMS) on the other. Perhaps more accurately, the band was warming up and the participants were making their introductions before CHRONIC became law, but now the ball is in full swing.
The American Society of Nephrology (ASN) has joined the world's leading organizations representing clinicians, laboratory researchers, and physician-scientists committed to improving patient care, in support the March for Science and its nonpartisan call for the
appreciation of scientific evidence, education, and investment. The March is being held today, Saturday, April 22nd, in Washington, D.C. and 604 other cities around the globe.
New opportunities to join Advanced Alternative Payment Models (APMs)
Why Join an Advanced APM?
First, you need to evaluate your practice to determine your best fit under the new Quality Payment Program (QPP):
Alternative Payment Models (APMs) – especially Advanced APMs or
Merit-based Incentive Payment Program
Some good news out of Washington: Major gains for kidney patients and nephrologists were proposed Thursday, October 27, by the Senate Finance Committee (SFC).
The Committee’s bipartisan Chronic Care Working Group released draft legislation to improve outcomes for Medicare patients living with chronic conditions – including kidney disease. Numerous provisions ASN advocated for are included in the draft bill, such as allowing patients using home dialysis to interact with their nephrologist via telemedicine from home, and permitting ESRD patients the option to enroll in Medicare Advantage plans (which is not presently allowed).
