Policy and Politics News

Data security issues captured headlines in 2014. A number of large corporations had well-publicized breaches of consumer information. With the attention on data security, many health care providers have sought to stay out of the limelight by developing a robust compliance program to protect patient data and be in compliance with the Health Insurance Portability and Protection Act. A breach of HIPAA can lead to private lawsuits, reputational harms, and civil and criminal actions by the Office for Civil Rights (OCR) and Department of Justice (DOJ). Recent civil actions taken by the OCR highlight the importance of understanding and complying with the evolving HIPAA rules and regulations. Enforcement actions were not confined to certain types or sizes of providers nor were they limited to “egregious” cases.

Back in 1989: a U.S.-led conference held in Dallas focused on the persistent rise in mortality among dialysis patients. Clinicians in the United States thought it was a worldwide problem. Experts from other countries came and brought their data. The conclusion: the 20% mortality rate in the U.S. was not shared by other countries. It was something we were doing wrong. Everyone went home.

More than 750 organizations joined the American Medical Association (AMA) to call on Congress to pass legislation that would permanently eliminate Medicare's sustainable growth rate (SGR) formula. In a letter to House and Senate leadership, the groups urged policymakers to pass the bipartisan, bicameral framework developed last year.

Congress is racing toward a March 31 deadline to replace the much-maligned sustainable growth rate formula, used to determine Medicare payment for physicians, with a more progressive pay-for-performance model.  Missing the deadline would mean nephrologists and other specialists paid by Medicare will face a more than 20% payment cut April 1.

Confirming an opinion released via a voice vote last month, the Medicare Payment Advisory Commission announced in its March written report to Congress that dialysis facilities did not need an increase in the bundled payment for 2016.

A study published in the March issue of the American Journal of Kidney Diseases projects that the number of new cases of chronic kidney disease (pre-dialysis) will grow significantly through 2030. More than half the U.S. adults aged 30 to 64 years are likely to develop CKD.

In Part 1 of this two-part series on the ESRD Core Survey developed by the Centers for Medicare and Medicaid Services, I concentrated on collaboration, facility-based program preparation, control of environmental hazards, and culture of safety. Part two of this series will review how the surveyors participate in direct observation of treatment prescription delivery, infection control practices, water safety, and performance improvement through unit-wide action plan strategies.

The Senate and House of Representatives have introduced the "The Chronic Kidney Disease Improvement in Research and Treatment Act" (H.R. 1130, S. 598),a bill that supports improvements in the research, treatment, and care of chronic kidney disease. The bill is similar to one introduced in June 2014, by both legislative bodies. 

Levels of a protein in the urine may help clinicians predict which patients with acute heart failure are at increased risk of developing kidney injury during hospitalization, according to a study conducted by  Xiaobing Yang, MD, Fan Fan Hou, MD, PhD,  and colleagues from Southern Medical University in Guangzhou, China. The study, entitled "Urinary Angiotensinogen Level Predicts AKI in Acute Decompensated Heart Failure: A Prospective, Two-Stage Study," appears in an upcoming issue of the Journal of the American Society of Nephrology .

On Feb. 13, the Kidney Care Partners sent recommendations for the ESRD Five Star Technical Expert Panel in a letter to Centers for Medicare & Medicaid Services administrator Marilyn Tavenner.