Kidney Care Partners Applauds Introduction of the Restore Protections for Dialysis Patients Act
December 20, 2023
WASHINGTON – Kidney Care Partners (KCP) – the nation’s largest non-profit, non-partisan kidney care coalition dedicated to protecting access and comprised of more than 30 organizations, including patients, dialysis professionals, physicians, nurses, researchers, therapeutic innovators, transplant coordinators, and manufacturers – today applauded Representatives Mike Kelly (R-PA), Yvette Clarke (D-NY), Neal Dunn, MD (R-FL), Danny Davis (D-IL), John Joyce, MD (R-PA) and Raul Ruiz, MD (D-CA) for introducing the bipartisan Restore Protections for Dialysis Patients Act (H.R. 6860).
If passed, this bill would restore the intent of the Medicare Secondary Payer Act (MSPA) Congress adopted 40 years ago, to protect individuals with end-stage renal disease (ERSD), or kidney failure, from group health plan discrimination. Unfortunately, the MSPA was upended in the Supreme Court case Marietta v. DaVita, which effectively allows employer group health plans to target patients with kidney failure by carving out kidney care services, including dialysis treatments and access to nephrologists or other specialists that these individuals need to survive, effectively forcing them off of their private plans and onto Medicare before they would otherwise elect to do so. As a result, patients often are forced to pay more out-of-pocket or lose additional health benefits like dental or vision coverage. The shift in payer coverage also puts additional pressure on the sustainability of our nation’s Medicare program.
To address this gap, the Restore Protections for Dialysis Patients Act would prevent discrimination against patients with kidney failure as Congress originally sought under the MSPA and ensure that patients can continue to access the life-saving dialysis care they need on their private insurance throughout the statutory 30-month coordination period.
“As the leading voice for the nation’s kidney care community, Kidney Care Partners is devoted to ensuring that all ESRD patients can access safe, effective care with coverage of their choice,” said John P. Butler, Chair of Kidney Care Partners. “We thank House lawmakers for introducing the Restore Protections for Dialysis Patients Act, which will protect patient access to private insurer coverage for life-sustaining dialysis treatments.”
Leading patient and physician groups are also hailing the introduction of this critical legislation as a vital and necessary step to improve patient care.
“People with ESRD are more likely to be low-income and from historically marginalized communities, making premature loss of health coverage and related cost increases particularly devastating,” said LaVarne Burton, President and CEO of the American Kidney Fund (AKF). “Thankfully, the Restore Protections for Dialysis Patients Act will ensure that people with kidney failure won’t be singled out based on their disease or forced to pay higher costs.”
“We thank Representatives Kelly, Clarke, Dunn, Davis, Joyce and Ruiz for introducing this pivotal legislation, which will preserve patient choice and incentivize health plans to detect and treat chronic kidney disease (CKD). Unfortunately, my health insurance plan continues to restrict my access to the therapies that my nephrologist has prescribed to delay my kidney disease progression. Without action by Congress, millions of Americans could see their insurers follow suit, as the sooner they can push CKD patients like me into Medicare without paying any cost for doing so, the more likely we are to progress to end-stage renal disease (ESRD),” said Hrant Jamgochian, J.D., LL.M., CEO of Dialysis Patient Citizens.
“Private insurance can be vital to patients’ access to care and plays a critical role in ensuring the stability of the Medicare system,” said Keith A. Bellovich, DO, President of the Renal Physicians Association. “I urge House lawmakers to swiftly advance this legislation, which will make a meaningful difference for the more than 800,000 patients living with kidney failure.”
“The Marietta v. DaVita decision will force people who have kidney failure off their private insurance into Medicare,” said Lori Hartwell, Founder and President of the Renal Support Network. “Health plans should not be able to decide they don’t want to cover you when your kidneys fail, a critical time when you need your insurance and care team the most. It is an unfair, discriminatory policy and a slippery slope for other chronic conditions.”