CARES Act to Improve Options for People on Home Dialysis


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.

Senator Todd Young of Indiana was instrumental in the inclusion of the home dialysis waiver, providing HHS the authority to allow all visits to be done by telehealth. In a press release, directed towards his constituents, Senator Young said “This emergency relief package is designed to help Hoosier families, workers, job creators, healthcare heroes on the front lines, patients, and everyone who has suffered through no fault of their own…we are going to get through this by working together, and we are going to come out stronger.”

The CARES Act also codifies the Centers for Medicare and Medicaid Services (CMS) policy on both new and existing patients being eligible for telehealth evaluations announced by CMS on March 17, 2020.  The CARES Act states that a physician is not required to have that treatment relationship with a new patient to be reimbursed for telehealth services for the duration of the COVID-19 emergency period.

The CARES Act represents the third stimulus bill passed by Congress in response to the COVID-19 pandemic. With more than $2 trillion in allocations, it is the largest stimulus bill in US history. The sweeping legislation directs $100 billion to an emergency fund accessible by eligible healthcare providers and provides additional low-interest and small business loan support to businesses combatting the COVID-19 outbreak. Other key provisions boost Medicare and Medicaid reimbursement for COVID-19-related inpatient services and generally, expand testing and treatment coverage, and provide additional regulatory relief for rural providers.

ASN will work with HHS to operationalize the issuing of emergency telehealth waivers and continue to urge lawmakers to ensure optimal care of kidney patients and the wellbeing of their care team during the COVID-19 pandemic. Members of the ASN Policy and Advocacy Committee, the ASN Quality Committee, and the American Association of Kidney Patients will be on the Hill on Wednesday, April 1 to discuss further action that must take place on behalf of kidney patients during the pandemic.

*Coronavirus Aid, Relief, and Economic Security Act.