Kidney Patients' Health Is Jeopardized by Proposed Medica...( New Report on the Medicare End St...),Health

New Report on the Medicare End Stage Renal Disease Program Recommends Policy Changes and Urges Focus on Innovation, Prevention, and Awareness

WASHINGTON, Dec. 10 /PRNewswire-USNewswire/ -- The Association of Minority Nephrologists and the National Minority Quality Forum today released a consensus report addressing proposed changes to the Medicare End Stage Renal Disease (ESRD) Program that are currently being considered by the U.S. Congress.

The House has passed the proposed changes, and the Senate will consider them soon. The purpose of the changes is to contain ESRD Program costs in the short term by reimbursing providers of ESRD care with a single payment for the complete range of treatments provided to ESRD patients.

Medicare is the primary payer for 80 percent of the more than 485,000 ESRD patients in the United States.(i) Currently, the Medicare ESRD Program pays an estimated $20 billion for ESRD patients' dialysis, transplantation, and inpatient and outpatient care. Dialysis units are reimbursed for each treatment at a "composite rate" that is set by the government to cover the fixed costs of nursing, supplies, and equipment. They receive separate payments to cover the costs of some injectable drugs and diagnostic tests. Congress is currently considering legislation that would bring all Medicare ESRD services under a single, "fully bundled" rate.

The report finds that as early as the 1990s, previous Congresses had commissioned reviews of a fully bundled rate. These reviews found that bundling had the potential to deny beneficiaries access to medically necessary therapies. Proceeding with appropriate caution, under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), the 106th Congress mandated that the Centers for Medicare and Medicaid Services (CMS) complete a bundling demonstration project by 2006 to avoid any risk to patients. Because of the complexity of designing a demonstration of f
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