Washington, D.C. – Today, U.S. Reps. Terri Sewell (AL-07) and Vern Buchanan (FL-16) introduced the Chronic Kidney Disease Improvement in Research and Treatment Act. This bipartisan legislation would improve research and treatment for chronic kidney disease and kidney failure by increasing awareness and education, improving payments systems, incentivizing innovation, and expanding patient choices.

“Tens of millions of Americans are impacted by kidney disease,” said Rep. Sewell. “For too many Alabamians, its negative health effects are accompanied by financial challenges and barriers to receiving care. Increasing access to quality, affordable health care continues to be one of my top priorities in Congress, and I’m so proud to introduce the Chronic Kidney Disease Improvement in Research and Treatment Act. This legislation will make critical improvements to the way patients with kidney disease, especially those in underserved communities, access and receive care.”

“Tragically, kidney disease affects more than one in 10 Americans, many of whom have trouble accessing quality care,” said Rep. Buchanan, lead Republican co-sponsor. “This important legislation incentivizes innovative new treatments for kidney disease, expands access to dialysis and transplants in underserved communities and ultimately improves the quality of life for those living with these chronic conditions.”

The Centers for Disease Control and Prevention (CDC) estimates that as many as 15% of U.S. adults – approximately 37 million people – suffer from Chronic Kidney Disease (CKD). Of those with CKD, as many as 9 in 10 are undiagnosed. As the disease progresses and kidney function worsens, patients risk developing kidney failure, also known as end-stage renal disease (ESRD). According to the CDC, in the year 2018 alone, treating Medicare beneficiaries with CKD cost over $81.8 billion and treating people with ESRD cost an additional $36.6 billion. Kidney diseases are the ninth leading cause of death in the United States.

The Chronic Kidney Disease Improvement in Research and Treatment Act would:

• Increase Kidney Disease Awareness and Education 

  • The bill would increase detection of kidney disease by expanding the Medicare Annual Wellness Benefit to include kidney disease screening.

  • It would also increase access to the Medicare Kidney Disease Education Benefit by allowing dialysis facilities to provide kidney disease education services and permit physician assistants, nurse practitioners, and clinical nurse specialists, in addition to physicians, to serve as referral sources for the benefit.

• Create an Economically Stable Dialysis Infrastructure and Incentivize Innovation

  • The bill would make important changes to the ESRD payment system to improve accuracy in payment and support innovative therapies.

  • It would incentivize innovation by requiring the Secretary of Health and Human Services to adjust the ESRD Prospective Payment System bundled rate when the current rate would not cover the cost of adding a new drug, biologic, device, or other technology into the bundle after the transitional payment period ends. 

• Improve the Accuracy and Transparency of ESRD Quality Programs 

  • The bill would reform how the Centers for Medicare and Medicaid Services (CMS) adopts measures used in the ESRD Quality Incentive Program (QIP) to ensure there are a set of meaningful, valid, and reliable measures. 

  • It would establish QIP bonus payments for facilities exceeding the attainment performance standards. 

  • It would also improve patient decision-making by eliminating contradictions between the ESRD QIP and Five Star programs.

• Expand Patient Choice of Coverage

  • The bill would guarantee access to Medigap policies to all ESRD Medicare beneficiaries, regardless of age.

  • It would allow patients with ESRD to retain private insurance as their primary payer for an additional 12 months.

  • The bill would protect patient access to Medicare Advantage plans by requiring the Department of Health and Human Services to reinstate dialysis services as an area subject to the Network Adequacy requirements.