More than 200 Representatives sign letter urging caution over cuts to ESRD bundle

More than 200 members of the U.S. House of Representatives signed a letter to the Centers for Medicare and Medicaid Services' administrator, urging caution and expressing concern over proposed cuts to Medicare’s End-Stage Renal Disease (ESRD) program.

The bipartisan effort was initiated by Representatives Diane Black (R-Tenn.), John Lewis (D-Ga.), John Shimkus (R-Ill.) and Ben Ray Lujan (D-N.M.) quickly gained momentum among both parties as Congress drew to a close for August Congressional recess. Many of the more than 200 members who signed the letter had heard from kidney organizations and individuals about the negative consequences the proposed cuts would have on staffing, access and quality of care, according to Kidney Care Partners.

CMS released a proposed rule on July 1 to trim 12% off the composite rate in the ESRD bundle to make up for significant drops in the use of anemia drugs. The cut would actually amount to 9.4%, because the agency would give the renal community a 2.6% increase based on the market basket analysis for 2014. If finalized later this year, the proposed changes to the Prospective Payment System for the ESRD Program would reduce the Medicare composite base rate from $240.36 per dialysis patient per treatment to $216.95 per treatment.

The following is an excerpt from the letter. Download the full letter here.

"The new bundled payment system for dialysis has been a remarkable success in payment reform. However, as written, the new proposed rule would have a devastating impact on Medicare beneficiaries who desperately depend on dialysis treatments just to stay alive.

The proposed cut in payn1ents in the pending rule constitute a 12% or a $30 reduction of what would otherwise be $246 prospective payment for dialysis. A cu t of this magnitude to an industry that, according to the Medicare Payment Advisory Commissi on, has just 3-4% Medicare margins, could result in closure of dialysis facilities and a reversal of ma ny recent gains that have been made in im proving quali ty of care and mortality for dialysis patients."