Legislators ask CMS to allow use of home dialysis for patients with AKI
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Key takeaways:
- Legislators sent a letter to CMS requesting the agency expand availability of home dialysis to patients with AKI.
- The number of patients with AKI who recover kidney function varies in the outpatient setting.
Lawmakers are asking CMS to expand availability of home dialysis for Medicare beneficiaries receiving treatment for AKI in an outpatient setting.
In a letter to CMS Administrator Chiquita Brooks-LaSure, U.S. Reps. Suzan K. DelBene, D-Wash.; Carol D. Miller, D-WVa.; Tony Cárdenas, D-Calif.; and Larry Bucshon, MD, R-Ind., wrote that Medicare officials should allow patients at risk for or currently diagnosed with AKI to choose a home modality option.
The legislators asked in the letter that the agency make the change to be included in its final rule covering updates for the Prospective Payment System for 2024.
“Giving patients the option to receive dialysis at home can dramatically improve health outcomes and quality of life. Unfortunately, the U.S. ranks far behind other comparable countries in use of home dialysis,” the legislators wrote. “As you work to finalize the Calendar Year 2024 End-Stage Renal Disease (ESRD) Prospective Payment System rule, we urge you to expand access to home dialysis for the millions of Americans who either have or are at risk of kidney failure. To advance that goal, we believe that [CMS] should cover home dialysis for Medicare patients with (AKI) if they are no longer hospitalized and have decided, along with their doctor, that home dialysis is the right choice for them as they attempt to regain kidney function.”
Starting in 2017, Medicare Part B began including coverage for renal dialysis services furnished by a facility or provider for a Medicare beneficiary with AKI, but only allowed coverage for in-center hemodialysis. The percentage of recovery of kidney function varies among patients with AKI; one study showed that one in three patients recovered kidney function within the first 90 days of transferring to an outpatient dialysis clinic.
“We strongly urge Medicare to do all in its power to expand access to home dialysis, including for AKI patients,” the lawmakers wrote. “Increasing access and improving outcomes for AKI patients is especially important because these patients have the potential to recover kidney function and avoid permanent kidney failure requiring years of dialysis or transplant.
“Home dialysis for AKI would allow patients to receive care in a more comfortable setting, have more control over their schedules and potentially avoid their condition worsening to kidney failure that requires permanent dialysis or transplant,” the legislators wrote.
Reference:
https://www.healio.com/news/nephrology/20180227/new-law-allows-outpatient-dialysis-clinics-to-trea
https://www.healio.com/news/nephrology/20211223/some-aki-survivors-who-require-hemodialysis-recover-kidney-function
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