Kidney Care Partners (KCP) – the nation’s largest non-profit, non-partisan coalition of more than 30 organizations, comprising patients, dialysis professionals, physicians, nurses, researchers, therapeutic innovators, transplant coordinators, and manufacturers – today, expressed deep disappointment in the Supreme Court ruling on Marietta Memorial Hospital Employee Benefit Health Plan v. DaVita, citing concern about discrimination in accessing affordable quality care for individuals living with end-stage renal disease (ESRD) and its impact on growing health inequities.
“The insurer practice at issue – shifting patients prematurely to Medicare – will exacerbate inequalities in access and quality care for an already vulnerable population. This ruling is a blow to promoting affordable patient choice and instead unfairly shifts costs to the American taxpayer. We feel this decision leaves patients with ESRD vulnerable to discriminatory and inequitable insurer practices, and in fact, is not consistent with the Administration’s own goals on health equity,” said John P. Butler, Chair of KCP.
Premature loss of private group health coverage can be devastating for some patients living with ESRD. Often, private insurance plans offer more coverage options than Medicare does. Some of these services, such as dental coverage, can be essential in controlling infections that, if not caught early, can exclude a patient from transplant waitlists. More comprehensive disease management services can provide better outcomes by helping to manage other chronic diseases common in patients requiring dialysis. Private insurance may, in some cases, also provide lower copays and deductibles and limits on out-of-pocket costs than Medicare. When a patient living with ESRD loses private insurance coverage, the consequences can also extend to other family members under that policy who do not qualify for Medicare and may face substantially higher costs, deductibles, and other cost requirements resulting from that loss of coverage.
“Despite this ruling, KCP remains steadfast in our commitment to ensuring equitable, affordable access to quality care for the millions of individuals living with or at risk for kidney disease,” said Butler. “We stand ready and willing to work with Congress and other policymakers to address the gap created by today’s ruling and clarify the intent of the Medicare Secondary Payor Act to better protect patients from exclusionary measures like this. More must be done to ensure that no one is denied or discriminated against because of the treatment they need because of their disease.”
The issue in the case was whether a group health insurance plan that limited access to outpatient dialysis treatments violated the Medicare Secondary Payer statute by discriminating against patients based on their need for dialysis. In January, KCP filed an amicus brief that argued that the health plan discriminated against those with ESRD by limiting coverage for life-sustaining treatment, thereby forcing patients to drop private group coverage, and financial protections, in favor of Medicare. The recent Supreme Court opinion disagreed with that argument.
Kidney Care Partners
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Kidney Care Partners (KCP) – the nation’s largest non-profit kidney care coalition of more than 30 organizations, comprising patients, physicians, nurses, researchers, transplant coordinators, dialysis professionals, therapeutic innovators and manufacturers– recently announced the community’s policy priorities for 2022.
KCP is dedicated to working on issues ranging across the full spectrum of the kidney disease continuum from education and prevention to early intervention to dialysis and, finally, to transplant and post-transplant care. The recently released policy priorities document outlines four key areas of focus:
· Supporting patient choice in treatment options;
· Reforming the Medicare ESRD Benefit;
· Advancing kidney care quality; and
· Addressing issues related to COVID-19.
“Every individual living with kidney disease, end stage renal disease (ESRD), and kidney transplant must have access to a variety of appropriate, innovative treatment modalities and coverage options, regardless of their age or location,” said Michele Kimball, executive director of KCP. “This includes expanded home dialysis choice, access to innovative products and services, removing barriers for donor waitlists, living donor education, and ensuring those living with kidney disease have the same insurance options as other Americans.”
KCP notes in its policy priorities that the organization is also committed to reforming the Medicare ESRD Benefit to support innovative care options, promote patient choice, and eliminate barriers to care by seeking new payment models and preventing Congress from using ESRD-specific offsets for other policies.
Additionally, the coalition is working to advance kidney care quality by seeking to streamline the quality programs and ensure appropriate implementation for the Quality Incentive Program (QIP) and Five Star, as well as seeking the passage of the bipartisan, bicameral Chronic Kidney Disease Improvement in Research and Treatment Act (S. 1971/H.R. 4065).
KCP also continues to support and advocate for policies that help to best address the COVID-19 pandemic for those living with kidney disease, individuals receiving dialysis treatments, and kidney transplant recipients.
“These priorities demonstrate KCP’s ongoing commitment to advancing policies that meet patients’ needs at every stage along the care continuum,” said John P. Butler, Chair of KCP. “Our diverse membership is proud to unite around this shared vision for a future of patient-centered, quality-driven kidney care.”
To learn more about KCP’s 2022 policy priorities, Click here.
Kidney Care Partners (KCP) – a non-profit coalition of more than 30 organizations, comprising patients, dialysis professionals, physicians, nurses, researchers, therapeutic innovators, transplant coordinators and manufacturers – has submitted comments through the Centers for Medicare & Medicaid Services (CMS) to the U.S. Department of Health & Human Services (HHS) in response to the Agency’s request for information (RFI) on kidney care improvements. This request focused on how to advance equity and reduce disparities in organ transplantation, improve life-saving donations, provide individuals with CKD with access to more preventative services, promote greater care coordination for individuals receiving dialysis and empower individuals when making decisions about their treatment options, including removing socio-economic barriers to selecting home dialysis.
“We’re very pleased to see HHS and CMS spotlight the unique needs of the more than 37 million Americans living with kidney disease, kidney failure, and kidney transplants by calling on the kidney community to come together with actionable, tangible recommendations to improve care,” said John P. Butler, Chair of KCP. “Given that individuals with kidney disease are disproportionately from communities of color and often experience inequities in the delivery of care, now is the time to investigate, invest in, and implement policies that will improve access and choice to quality care and innovations for all.”
The response letter, written with input from leadership among KCP members from across the kidney care continuum, addresses a broad range of topics, emphasizing improving the organ and transplantation ecosystem and delivering care to individuals with chronic kidney disease (CKD) and end stage renal disease (ESRD). KCP brought together experts in each of the topic areas of the RFI – CKD, dialysis, and transplant – in a series of half-day working sessions to build the consensus recommendations.
Regarding transplants, KCP’s letter notes that “the current processes involved in waitlisting a patient leads to only a fraction of patients being actually listed.” Policy recommendations to address this issue include enhancing education and communication to patients around transplant, increasing transplant data transparency and addressing patient access issues, among others.
KCP specifically calls on HHS and CMS to “eliminate the silos within the health information system and ensure that all providers in the kidney care community can have a 360-degree view of patients’ health data” to improve care coordination and patient outcomes.
KCP also recommended that “HHS work across its agencies and with other stakeholders to slow the progression of CKD and empower patients to select the modality that works best for them” when considering their health care choices.
The comment letter specifically highlights the work of Senators Ben Cardin (D-MD) and Roy Blunt (R-MO) along with Representatives Terri Sewell (D-AL) and Vern Buchanan (R-FL) who have introduced The Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 (H.R. 4065/ S. 1971) that would address shortcomings of the current Kidney Disease Education benefit (KDE) in Medicare and expand it to allow more patients access to KDE services and permit more providers to offer these services. The legislation would also increase awareness among beneficiaries by incorporating CKD screening in the annual Medicare wellness visit.
Additional recommendations in KCP’s response include expanding telehealth access, increasing education and awareness of kidney disease and incentivizing providers to help slow disease progression to delay or avoid ESRD altogether.
KCP also calls on the Administration to remove artificial restrictions that make it difficult for dialysis facilities and nephrologists to support patients whose socio-economic status creates barriers that can prevent them from accessing home dialysis options or receiving a transplant.
“The potential for individuals with kidney diseases to live longer and fuller lives is better than ever, but there’s still much more to be done,” said Michele Kimball, Executive Director of KCP. “KCP has always been a leading advocate for patients and pro-patient policies, and we look forward to working with HHS, CMS, and other stakeholder groups to expand options and choices for patients that drive changes for even better access to quality care and improved outcomes.”
To view the full response from KCP, click here.