Policy and Politics News

Voters in California turned down a union-backed ballot initiative by a majority yesterday that would have restricted profits of dialysis providers operating in the state.

Millions of voters across the United States are making decisions today on political candidates, municipal bond proposals, and, in some states, whether marijuana should be legalized. In California, voters will determine if state regulators should control how much profit dialysis providers operating in that state should make.

One year ago, CMS administrator Seema Verma announced the launch of the agency’s new Patients over Paperwork Initiative. This commendable effort established listening sessions, customer-centered workgroups and mapped a course to reduce regulatory burden, improve the logic of outcomes measures, enhance patient access to their own data and simplify documentation requirements. Their laudable goal is “reducing administrative burden while improving care coordination, health outcomes and patients’ ability to make decisions about their own care.”1

During the first three years of expansion, fewer patients with ESRD died within a year of starting dialysis in states that expanded Medicaid coverage under the Affordable Care Act compared with patients in states that did not expand care.

The Service Employees International Union-United Healthcare Workers West has released results from a poll conducted by SurveyUSA that indicates voters in California favor Proposition 8, an initiative on the Nov. 6 ballot that would limit profits of dialysis providers operating in the state.

Novitas Solutions, the Medicare Administrative Contractor for states in the Middle Atlantic, South/Southwest and Western regions, has released a proposed local coverage determination that would eliminate the ability of nephrologists to perform endovenous stenting in their offices. The stenting is used primarily for vascular access placement.

Twenty-seven senators and representatives from both sides of the Congressional aisle signed a letter to HHS Secretary Alex Azar saying they oppose proposed Medicare payment cuts to vascular access services for patients on dialysis.

A U.S. House and Senate conference report that is part of the 2019 appropriations spending package recently signed by President Donald J. Trump includes a push for more research in pediatric kidney disease and for a CMS-directed study on determining the cost of lifetime coverage for anti-rejection drugs for transplant patients.

A group of medical societies has written CMS Administrator Seema Verma asking that the agency reconsider changes being proposed to documentation guidelines and payment policies for evaluation and management codes used by physicians.

A recent gathering of health care agencies and kidney care advocacy groups on Capitol Hill helped to launch some new initiatives for improving kidney care in the future.