Advocacy produced wins for nephrology in 2020; vaccine, telehealth still high priorities
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Amid news about improved Medicare reimbursement and immunosuppressive drug coverage for patients with a kidney transplant, the nephrology community still has some unfinished business in the regulatory environment for 2021, a speaker said.
“[The year] 2020 was a great advocacy year for nephrology,” Robert Blaser, director of public policy for the Renal Physicians Association, said during the organization’s virtual conference. “Congress passed the immunosuppressive drug coverage bill, something that has been on our legislative agenda for over a decade, and something we cared about for 10 years before that,” Blaser said.
Medicare also added $270 million in updates to various outpatient dialysis payment codes for nephrologists. “They all had value increases between 13% and 27%,” with only one outpatient code, for pediatric nephrology, going without an increase in payment, Blaser said.
The changes “led to a projected increase in nephrology payment of 11% effective in 2021,” he said. Changes were also made in payment codes for the care of patients with chronic kidney disease at stage 3, and new payment codes were added for vascular access.
Payment for the Kidney Care Choices voluntary models, which have been delayed until January 2022, improved compared with the original policy: nephrologists will now get paid the full monthly capitated payment for patients with end-stage kidney disease vs. the previously proposed two to three payments per month. The payments will also go directly to the nephrology practices, Blaser said. CMS had previously proposed to create a new entity to distribute payment.
New legislation has been introduced this year to help make access to telehealth for patients and providers permanent. House bill 366, called the “Protecting Access to Post-COVID-19 Telehealth Act,” and sponsored by Rep. Mike Thompson, D-Calif., would permanently remove the originating site and geographic restrictions on use of telehealth, Blaser said. “This bill may be in the ‘sweet spot’ for passage because of the COVID-19 pandemic and the bill has strong bipartisan support,” he said.
However, getting priority status for patients on dialysis to receive the COVID-19 vaccine remains a top issue, Blaser said. The RPA and other organizations have sent letters to the Biden administration requesting patients on dialysis and their families receive high priority and allow dialysis providers to administer the vaccine.
“This has become an emergent policy issue for the kidney community,” Blaser said. “Vaccine distribution is job 1, 2 [and] 3.”
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Blaser R. RPA advocacy agenda. Presented at: RPA Annual Meeting. March 18-20 2021 (virtual meeting).
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