Legislators reintroduce bill to cover more screenings for CKD, expand Medigap coverage
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Key takeaways:
- Legislators have reintroduced a bill that would expand coverage for health screenings for chronic kidney disease.
- The bill offers financial incentives to dialysis providers who use innovative products.
Members of the U.S. Senate have reintroduced a bill that would provide Medicare funding for preventive screenings for kidney disease, add payments for innovative devices and allow patients younger than 65 years to buy Medigap coverage.
The bill, called The Chronic Kidney Disease Improvement in Research and Treatment Act, was introduced by U.S. Sens. Benjamin L. Cardin, D-Md., and Marsha Blackburn, R-Tenn. A companion bill was introduced by U.S. Reps. Carol Miller, R-W.Va., and Terri Sewell, D-Ala., in the House of Representatives last year.
Similar to the House bill and detailed in a press release from Kidney Care Partners, the legislation introduced by Cardin and Blackburn proposes the following:
- increase prevention efforts by adding screening for CKD to the annual Medicare wellness benefit;
- expand the End-Stage Renal Disease Kidney Disease Education benefit to allow dialysis facilities to provide kidney disease education services and permit physician assistants, nurse practitioners and clinical nurse specialists, in addition to physicians, to serve as referral sources for the benefit, as well as provide access to these services to Medicare beneficiaries with stage 5 CKD not yet on dialysis;
- require CMS to adjust the ESRD Prospective Payment System bundled rate when the current rate does not cover the cost of adding a new drug, biologic, device or other technology into the bundle after the transitional payment period ends and require HHS to provide direct payment adjustments to providers or facilities if it is found that the cost of covering drugs and devices increases the cost to Medicare Advantage plans above the contracted benefit;
- address the workforce shortage in nephrology by ensuring that kidney care providers receive accurate annual payment updates based on staffing needs;
- require HHS, not later than 18 months after enactment of the legislation, to submit a report to Congress on ways to increase kidney transplantation rates. The study would investigate disincentives in the Medicare payment systems for performing kidney transplants; identify practices used by states with higher-than-average donation rates; identify ways to increase deceased donation rates among historically underrepresented populations and identify barriers to increasing living donor rates;
- include nephrologists and nonphysician practitioners in the National Health Service Corp loan forgiveness program; and
- guarantee access to Medigap policies for Medicare beneficiaries with kidney failure regardless of age.
“We applaud Sens. Ben Cardin and Marsha Blackburn for their commitment to improving the lives of millions of Americans affected by kidney disease through the reintroduction of The Chronic Kidney Disease Improvement in Research and Treatment Act,” Mahesh Krishnan, MD, MPH, MBA, chair of Kidney Care Partners, said in the press release. “The challenges that the kidney care community faces today require bold and urgent solutions. We look forward to working alongside policymakers to continue to improve the care for patients across the kidney disease continuum.”
A provision in the bill would also delay the inclusion of phosphate-lowering oral-only drugs into the prospective payment system bundle until 2033, according to the release.
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