Policy and Politics News

DALLAS — The complexity of treating kidney disease and debate in the early days of the ESRD program regarding concerns about high mortality rates have led to the establishment of several large, publicly accessible databases that can help clinicians assess quality of care, Kevin Erickson, MD, said during his keynote address at the Annual Dialysis Conference. However, using data from these sources to create health care policy has some risks.

The California Assembly’s Health Committee voted March 19 to advance A.B. 290, a measure that would limit dialysis provider profits when insurance premiums are covered by third-party payers.

With a proposed rule for the 2020 ASC payment system expected to be released in late June or early July, the Renal Physicians Association has sent recommendations to CMS aimed at stabilizing the payment structure for vascular access services for patients with ESRD by maintaining current endovascular ambulatory payment classifications.

Saying that the payment system for the Medicare ESRD Program is “outdated” and “has some of the worst incentives in American health care,” HHS Secretary Alex M. Azar II announced on March 4 that the agency is developing new models that encourage a shift from paying for sick patients to one that focuses on improving outcomes, including use of more home dialysis, expanding financial incentives and access to organs for kidney transplantation, and a push for earlier detection and treatment of kidney disease.

Members of the U.S. House and Senate from New York, Washington state and Arkansas have introduced a bill in Congress to require employers to recognize living organ donors under the Family Medical Leave Act.

The Renal Physicians Association has joined the National Kidney Foundation in voicing concern about how changes to the Medicare Part D drug benefit program may limit access to certain immunosuppressive drugs for kidney transplant patients.

WellBound of Memphis, which is owned by dialysis provider Satellite Healthcare, has agreed to pay $3,246,000 to settle charges that it provided services to patients on home dialysis that were in violation of anti-kickback statutes.

Fresenius Medical Care has announced an extension of its merger agreement with NxStage Medical Inc. due to the U.S. government shutdown.

Less than 4 months after California Governor Edmund G. “Jerry” Brown Jr. vetoed legislation that would have allowed state health regulators to restrict outpatient dialysis center profits - and California voters turned down the idea at the polls last November - a California lawmaker has introduced a bill to bring back the plan along with restricting third party payers like the American Kidney Fund from covering insurance premiums for patients with ESRD.

Medicare profit margins for dialysis providers will still be less than break-even, but continued increases in the bundled payment rate and a new method of paying for dialysis drugs taking effect next year will narrow the loss, according to a review by the Medicare Payment Advisory Commission.