Legislation Targets Kidney Disease Research, Treatment Access, and Medicare ESRD Program Stability

Rachel Meyer
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While the news cycle in recent weeks has been laser-focused on Senate efforts and intra-party debates surrounding repeal and replacement of the Affordable Care Act, bright spots of bipartisan collaboration on other healthcare legislation are quietly proceeding on Capitol Hill.

The Chronic Kidney Disease Improvement in Research and Treatment Act of 2017, introduced in late May 2017, tackles three distinct areas of interest to the kidney community: research, access to treatment, and stability for the Medicare ESRD program. Introduced in the House by Rep. John Lewis (D-GA), Rep. Tom Marino (R-PA), and Rep. Peter Roskam (R-IL), the bill is a focal point for Kidney Care Partners (KCP)—a broad advocacy coalition of which ASN is a member. The ambitious legislation includes several provisions ASN advocated for. The society will be emphasizing these areas as it works in partnership with fellow KCP members and other stakeholders to raise awareness and build support for the bill in the coming months:

Eliminating barriers to transplantation

Calls on the Secretary of Health and Human Services to conduct a study on any disincentives in Medicare that create barriers to kidney transplants and to examine best practices to increase deceased and living organ donation rates.

Fostering adoption of new technology

Commissions the National Academy of Sciences to evaluate the ESRD payment system to identify barriers to adopting innovative technologies and make recommendations to eliminate the barriers.

Assessing palliative care opportunities

Requires the Government Accountability Office (GAO) to issue a report on the use and impacts of palliative care on those with ESRD.

Improving minority health

Tasks the Secretary of Health and Human Services to conduct a study to better understand the progression of kidney disease and treatment of kidney failure in minority populations.

Ensuring equitable access to transplantation

Guarantees patients with ESRD who are under 65 the ability to enroll in Medigap plans, secondary coverage without which many patients cannot become active on the transplant wait list (Medigap for patients under 65 is currently not available in 19 states).

Promoting access to home dialysis

Allows home dialysis patients to interact with their nephrologist (and allows the nephrologist to be paid) from their home via telehealth if they both so choose.

Increasing access to kidney disease education

Only 2% of eligible patients currently receive the kidney disease education benefits for which they are eligible; this bill would expand the providers who can offer the education and allow people with stage 5 CKD not yet on dialysis to access it.

Creating loan repayment for nephrologists

Permits nephrology health professionals in underserved rural and/or urban areas to participate in the National Health Service Corps loan forgiveness program.

Join ASN in advocating for enactment of this legislation: Contact your congressional representative at https://www.asn-online.org/policy/lac.aspx