Policy and Politics News

Last month, seven Medicare Administrative Contractors (MACs) simultaneously released proposed Local Coverage Determinations (LCDs), or payment policy rules, on how they would be covering more frequent hemodialysis (defined as beyond the standard three times/week covered in the bundled payment rate).

NxStage Medical Inc. and Fresenius Medical Care Holdings Inc. have each received a request for additional information from the U.S. Federal Trade Commission regarding Fresenius’ proposed acquisition of NxStage, according to an SEC filing. The request extends the waiting period required by the Hart Scott Rodino (HSR)Act until 30 days after both companies comply to the request.

First-year results from Medicare’s Comprehensive ESRD Care Model show that 12 of the 13 ESRD Seamless Care Organizations (ESCOs) that contracted with the agency for the five-year project received sharing savings—one as much as $12.3 million.

In January 2011, major payment reforms were implemented by the Centers for Medicare and Medicaid Services (CMS) for the treatment of patients with End-Stage Renal Disease (ESRD) on dialysis.1

On Oct. 5, Representative Kevin Cramer, R-N.D., introduced legislation that would amend the Affordable Care Act to allow third-party payments and charitable assistance. H.R. 3976, called the Access to Marketplace Insurance Act, would open the door to charitable contributions like the American Kidney Fund’s Health Insurance Premium Program (HIPP), which is funded largely by dialysis companies to help patients pay their health coverage premiums.

On Sept. 28, representatives introduced a bill, HR 3867, which would establish a Medicare pilot program to help improve care and outcomes for patients with chronic kidney disease. The legislation seeks to demonstrate that early detection of CKD, combined with effective and coordinated care that engages patients in the decision-making process, can improve clinical results and lower health care spending.

Last Friday, Department of Health and Human Services (HHS) secretary Dr. Tom Price sent in his forced resignation to President Donald Trump after a very short 7-month tenure. The health secretary’s departure topped a week in which a last-ditch GOP health care bill failed to advance in the Senate.

On Sept. 26, the U.S. Senate unanimously passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S.870). The bill, introduced by Senate Finance Committee Chair Orrin Hatch, R-Utah, in April, includes a section that expands the ability of Medicare beneficiaries on home dialysis to receive required monthly clinical assessments using telehealth, beginning in 2019.

The National Kidney Foundation has released the below statement opposing the U.S. Senate’s Graham-Cassidy health care bill, saying it will reduce access to care for people with kidney disease.

Four contractors that process Medicare payments for dialysis care –– covering 31 states and close to 60% of the U.S. end-stage renal disease population –– are proposing nearly identical policy changes that would tighten rules for paying for more than three-times-a-week dialysis treatments. The exception would be treatment for patients with acute comorbid conditions outside the plan of care.