CMS confirms access procedures for patients with ESKD are essential
CMS has confirmed vascular access procedures for patients with end-stage kidney disease are an essential service after dialysis providers reported they were having difficulty getting the surgeries scheduled during the COVID-19 pandemic.
“We have received feedback that providers are experiencing difficulties scheduling for placement or repair of arteriovenous fistulas, arteriovenous grafts and peritoneal dialysis catheters.” CMS wrote in a memo. “We wish to clarify that these planned procedures are essential in that establishing vascular access is crucial for end-stage renal disease (ESRD) patients to receive their life-sustaining dialysis treatments.”
The agency said it was concerned that without access to qualified surgeons, patients who need dialysis would have to resort to using catheters, which are linked to a higher rate of infection. “Without [a permanent access], temporary access would be established using catheters, which pose a significantly higher risk of infection, morbidity and mortality,” the agency wrote in the memo.
CMS had previously announced that access procedures were considered essential services during COVID-19 pandemic.
Also in the memo, the agency clarified the importance of organ transplantation during the pandemic.
“Following the release of CMS’ previously released guidance to defer nonessential surgical procedures ... we received notifications of transplant programs voluntarily inactivating some or all of its transplant services,” CMS wrote. “We wish to clarify that organ transplantation procedures are essential for patients that are suffering from irreversible organ failure. The delay of a transplant procedure may jeopardize the health and safety of a potential transplant recipient and any decision to delay such procedures should be made on a case by case basis by the medical providers, the patient, as well as local and state authorities with consideration given to factors such as staff and hospital resources and availability of necessary supplies and equipment.”