Senate bill would require health plans to continue dialysis coverage for 30 months
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Key takeaways:
- A U.S. Senate bill seeks to prevent health plans from limiting reimbursement for dialysis and effectively moving patients with kidney disease to Medicare.
- The bill is a companion to H.R. 6860.
A bipartisan bill introduced in the U.S. Senate would require private health plans to continue to pay for dialysis for beneficiaries with end-stage kidney disease while they coordinate a transition to Medicare coverage.
The Restore Protections for Dialysis Patients Act, introduced by U.S. Sens. Bill Cassidy, MD, R-La., Cory Booker, D-N.J., and Martin Heinrich, D-N.M., is a companion to H.R. 6860 introduced in December 2023.
As Healio previously reported, the bill is meant to address implications of a U.S. Supreme Court decision in June 2022 that ruled a hospital health plan could reimburse dialysis care for employees at a lower rate than that of Medicare. That ruling effectively allowed health plans to skirt the Medicare Secondary Payer Act (MSPA) requirement to reimburse for kidney care services for the first 30 months after a beneficiary begins dialysis or receives a kidney transplant.
If passed, the legislation would restore the MSPA protections for consumers.
“ESRD patients who rely on life-sustaining dialysis treatments should not be kicked off their health care plan when they need it most,” Cassidy said in a press release. “This legislation ensures patients are protected and have access to the care of their choosing.”
“The last thing patients should be worried about when dealing with kidney failure is being kicked off their insurance while undergoing treatment. I’m introducing the Restore Protections for Dialysis Patients Act to ensure New Mexico families can continue to access essential care when they need it most,” Heinrich said in the release.
The nonprofit kidney care coalition Kidney Care Partners said in a press release that the legislation would reduce out-of-pocket medical expenses for patients and limit financial strain on Medicare.
“Patients deserve to have a choice in their health coverage to ensure they can access the care they need,” Mahesh Krishnan, MD, MPH, MBA, chair of Kidney Care Partners, said in the release. “We’re grateful to Senate leaders stepping up and supporting this effort to restore long-standing protections to patient choice and look forward to continued collaboration with policymakers and those impacted by current policy to advance this bill.”
References:
H.R. 6860. https://www.congress.gov/118/bills/hr6860/BILLS-118hr6860ih.pdf. Published Dec. 19, 2023. Accessed Sept. 11, 2024.
Nation’s kidney community commends Senate introduction of Restore Protections for Dialysis Patients Act. https://kidneycarepartners.org/press/nations-kidney-community-commends-senate-introduction-of-restore-protections-for-dialysis-patients-act/. Published Sept. 11, 2024. Accessed Sept. 11, 2024.
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