Medicare Advantage: Challenges for people with ESRD and proposed improvements
The original purpose of Medicare Advantage (Part C), established as the “Medicare+Choice” program in 1997 and renamed Medicare Advantage in 2004, was to provide an alternative to original Medicare by offering equivalent coverage delivered by private health plans subject to Centers for Medicare & Medicaid regulation. These plans often include supplemental benefits and lower cost-sharing…
Proposed 1.9% Pay Bump Sparks Long-Term Stability Concerns Among Kidney Care Advocates
A coalition of kidney care patient advocates, physicians, dialysis providers and researchers is concerned about the sustainability of the end-stage renal disease payment system following CMS’ proposal to bump reimbursements nearly 2% for 2026 — an amount Kidney Care Partners says doesn’t reflect the actual inflationary increases in costs for labor, rent and medical supplies….
Kidney Care Advocates Call on Congress for Stronger Support
On June 11, 2025, Kidney Care Partners, a coalition of more than 25 kidney care stakeholders, visited Capitol Hill to urge members of Congress to support policies benefitting the millions of Americans with kidney disease. Click here to see the full article.
Congressmen reintroduce Dialysis Patients Act
U.S. Congressman Mike Kelly (R-PA), along with colleagues Yvette Clarke (D-NY), Neal Dunn, M.D. (R-FL), Danny Davis (D-IL), John Joyce, M.D. (R-PA), and Raul Ruiz (D-CA), announced the reintroduction of the Restore Protections for Dialysis Patients Act, bipartisan legislation that aims to ensure that individuals with End Stage Renal Disease (ESRD) continue to have equitable…
Dr. Mahesh Krishnan Of Kidney Care Partners On 5 Things We Must Do To Improve the US Healthcare System
We must figure out how to create settings that are most beneficial to the patient. Often, the site of care that is most convenient for the patient isn’t able to provide needed services. For example, within dialysis, there are services that could be done in the dialysis clinic but aren’t because it’s unclear what providers…
Phosphate binder rule is disease-specific discrimination
In April, CMS issued guidance for the inclusion of oral-only drugs in the end-stage renal disease bundled payment. The directive included Xphozah as a renal dialysis service. Xphozah, (tenapanor, Ardelyx) is a first-in-class phosphate absorption inhibitor approved to lower serum phosphorus levels for adults on dialysis. CMS intends to include the agent in the ESRD prospective…
CMS increases payment for dialysis facilities, includes oral-only drugs in the bundle
CMS issued a final rule increasing the End-stage Renal Disease Prospective Payment System base rate to dialysis facilities by about 2.7% to $273.82 beginning Jan. 1, 2025, according to an agency press release. The final rate is higher than the 2.2% increase to $273.20 in the proposed rule circulated in July and up from the 2024 base…
Discount criticism of N.J. library protection bill | Letters
As a healthcare professional, it’s my duty to ensure that dialysis treatment – a life-sustaining procedure over 20,000 New Jerseyans living with kidney failure depend on – is as accessible and seamless as possible. For over 40 years, that job was made easier by a law that provided patients on dialysis with the option to…
ESRD Pay Rule Cements Oral-Only Drugs In Bundled Payment Despite Stakeholder Opposition
CMS on Friday (Nov. 1) finalized a plan to add oral-only drugs to its End-Stage Renal Disease bundled payment system despite stakeholders’ efforts to delay the policy, including legislation passed by the House Energy & Commerce Committee that would have excluded the drugs from the ESRD bundling for another two years. Click here to see the full…
Life-sustaining dialysis care
Dialysis treatments, while essential, are also often a tiring process for patients with end-stage renal disease or kidney failure. As a nephrologist, it is my job to ensure that the 12-15 hours patients spend in the dialysis chair each week are as easy as possible. A Supreme Court decision, however, could make it much harder…