House of Representatives Speak Up About Proposed Cuts

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WASHINGTON—More than 200 members of the House of Representatives signed a letter to the nation's top Medicare official, urging caution and expressing concern over the recently proposed cuts to the Medicare end-stage renal disease (ESRD) program.

The proposed rule that was released on July 1 and caused a stir would cut funding for dialysis by 12 percent off of the combined rate in the ESRD bundle. The actual proposed cut would amount to 9.4 percent with a 2.6 percent based on the market basket analysis for 2014.

The bipartisan effort, initiated by Representatives Diane Black (R-TN), John Lewis (D-GA), John Shimkus (R-IL) and Ben Ray Lujan (D-NM) quickly gained momentum among both parties as Congress drew to a close for August Congressional recess.  Many of the members who signed the letter had heard from myriad kidney organizations and individuals about the negative consequences the proposed cuts would have on staffing, access and quality of care.  In a letter to their House colleagues, the four co-sponsors of the effort cited “enormous improvements in quality of care” and efficiency improvements over the past decade—trends the kidney community maintains will be jeopardized if the proposed cuts are implemented.

The most recent House letter follows similar strongly worded letters from members of both the Senate and House, the Congressional Black, Hispanic, and Asian Pacific-American Caucuses, as well as virtually every kidney patient, physician, nurse, and provider organization in the country.

The Medicare ESRD benefit currently covers nearly 85 percent of the more than 400,000 Americans with kidney failure who rely on this program for their life-sustaining dialysis. 

Each session, which takes 3 to 4 hours, cleanses the blood of toxins, since the patient’s kidneys no longer function.  Dialysis treatments most often occur in a dialysis center three times per week.  Because of patients' heavy reliance on Medicare to cover dialysis for this life-sustaining process, increasing numbers of elected officials have joined the kidney community in its unified opposition to the proposed deep cuts. According to kidney community leaders, if the proposed cuts are implemented, Medicare would fail to cover the cost for each beneficiary’s dialysis session.

Patient and professional organizations across the country agree that if the proposed rule becomes final, the cuts will have a devastating impact on the nation’s dialysis system, especially in some rural and inner city areas.  Kidney care leaders are urging CMS to reverse course before the rule is finalized following the 60-day comment period, which ends Sept. 1.  

"On July 1, exactly 40 years to the day that the Medicare ESRD benefit went into effect, the federal government released this proposal to dramatically cut dialysis reimbursement.  That commitment made to our most vulnerable Americans suffering from kidney failure is now in doubt,” said Ron Kuerbitz, chairman of Kidney Care Partners (KCP).  “Since July 1, we have been urging policy makers in Washington to live up to the commitment they made 40 years ago.  We hope the latest strong statement made by members of Congress will be weighed carefully by Medicare officials.  We are thankful for the House of Representative’s bipartisan effort to try and reverse this dangerous proposal."

Last week, basketball legend and kidney transplant recipient Alonzo Mourning was joined by national leaders of KCP, including Kuerbitz, as well as CEOs of the National Kidney Foundation, the American Kidney Fund, Dialysis Patient Citizens, and past chair of Renal Physicians Association, who together made their case to policymakers and elected officials about this issue.  

“When the leaders of our country’s top kidney patient organizations tell me they have a problem, then I know I have a problem, too,” said Mourning.  “One thing is for certain: cuts this deep will have consequences, and those consequences will end up hurting patients, eliminating jobs, and reversing quality improvements that have been made in recent years.”
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