Policy and Politics News

The Centers for Medicare & Medicaid Services used the rulemaking process last week to bring payment for acute kidney injury into the bundled payment system for dialysis care, making the therapy officially reimbursable in an outpatient setting.

The American Society of Nephrology has voiced its opposition to the Senate health care bill. In a letter to Senate Majority Leader Mitch McConnell, R-Ky., and Minority Leader Chuck Schumer, D-N.Y., ASN president Eleanor D. Lederer said the Better Care Reconciliation Act would “negatively impact millions of patients, particularly those with kidney failure, advanced kidney diseases, and other chronic illnesses.”

A high fraction of patients with a failing allograft return to renal replacement therapy (RRT) with a tunneled hemodialysis catheter (TC). A late-stage chronic kidney disease tracking tool for such patients may improve rates of permanent dialysis access use at the time of RRT initiation. We identified patients at risk of initiating dialysis without a permanent access and prompted providers to initiate care pathway interventions for dialysis preparation, including modality education, vein mapping, access surgeon visits, actual access placement and maturation evaluation (where applicable).

Legislation that would mandate staff to patient ratios in California dialysis clinics is scheduled to be heard by the California State Assembly Committee on Health June 26 at 1:30 p.m. PT. Senate Bill 349, called the Dialysis Patient Safety Act, passed the State Senate on a 24-15 vote May 31 and received its first reading before the State Assembly on June 1.

Legislation that would mandate staff to patient ratios in California dialysis clinics was approved by the State Senate on a 24-15 vote May 31 and received its first reading before the State Assembly on June 1.

A letter signed by 184 members of Congress asking the U.S. Department of Health and Human Services Secretary to require insurance companies to accept charitable premium assistance would help dialysis providers regain their footing with patients enrolled in commercial health plans.

DaVita Kidney Care, which along with other dialysis providers and health care groups is opposing a mandatory dialysis staff-to-patient ratio in California, is denying that it fired a patient care technician because of his support of the legislation.

On May 18, the Senate Finance Committee passed S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, the Renal Physicians Association reported.  The bill will now move on to the full Senate for evaluation.

California’s Senate Bill 349, called the Dialysis Patient Safety Act, has brought to the forefront a divide between clinic staff members and the patients they care for, and dialysis providers. Many dialysis nurses and patient care technicians have said they are stretched too thin and care for too many critically ill patients at once, putting lives at risk. Dialysis providers contend they are operating on thin margins in an already strictly regulated market.

Even though a lawsuit halted the Centers for Medicare & Medicaid Services’ from implementing an interim final rule that would have made new regulations for dialysis facilities that make premium payments for patients on qualified health plans provided on the federal marketplace, the American Kidney Fund, and the dialysis providers who support its Health Insurance Premium Program (HIPP), cannot shake allegations of steering patients to more profitable private insurance plans.