On Friday, the final rule to update Medicare payments to dialysis providers was released by the Centers for Medicare & Medic
aid Services (CMS). We are pleased to say that this extensive ruling is a step in the right direction for dialysis patients.
Back in July, CMS proposed cutting dialysis payments by over 9% for 2014. The final rule is an improvement over the proposal because average Medicare payments for dialysis in 2014 and 2015 will remain relatively unchanged. There is also a 50% increase in payments for home dialysis training.
A downside of this rule is that the total cut is still about 9% from today’s rate, but it will be phased in over 3-4 years.NKF is hopeful that the phased-in approach to dialysis payment cuts minimizes any immediate, negative impact on patients’ access to quality care. We still have many long-term concerns with this payment system. Specific areas of concern include overcrowded facilities due to possible closures and consolidations, and over-burdened staff due to hiring freezes that reduce patients’ ability to access much-needed expert services such as nutritional counseling and social work. Additionally, cuts may result in providers offering fewer convenient treatment times due to consolidation. This may also hinder access to longer treatment times, which improves patient outcomes according to recent research.
While the full cut will still be implemented over the next few years, it is undeniable that CMS paid close attention to concerns raised by the National Kidney Foundation, and more importantly, our constituents. Your advocacy efforts, letters and phone calls helped shape a better outcome for dialysis patients across the U.S. next year.
Obviously, our work is not over. There are issues we will need to continue pressing in order to secure a better future for all kidney patients. This is why it is so important for kidney patients to play an active role in their health and the decisions that could impact their care. We encourage all kidney patients to get involved by visiting our Advocacy Center and signing up to receive action updates to have your voice heard in Washington. Together, we will continue to make sure kidney patients have access to the care and treatments they need, because advocacy works.
Advocacy in Action 
What ever happened to the bills in both the House and the Senate to have Medicare extend payment for immunosuppressant drugs beyond 36-months after Transplant ?
Hi Keith, The Medicare extension for immunosuppressive drugs for kidney recipients remains a top priority for us. This legislation continues to gain support, thanks to the work of our advocates.
Erin Kahle
National Kidney Foundation
Constituent Services Director
I have been solicting Senators and Congressman here in Colorado to Co-Sponsor these bills currently in Congress. My wish is that Transplant Patients in other States would do the same. Although the extension of the current Medicare rule of 36-months after transplant would pose a cost impact to Medicare the cost of these same patients returning to Dialysis would be far greater of an impact to Medicare. I think if the Senators and Congressman considering these bills were educated to understand what passage of these bills mean to a Transplant Patient and Medicare from a cost impact standpoint they would unamassily approve of these bills.
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Seems pretty stupid to not help make sure transplant patients get their drugs when it’s much cheaper than to take care of them on dialysis.
Carmen Arnold mother of a transplant patient. My son had live kidney transplant 2 1/2 yrs ago, leaving him 6 more months before the 36 months ends after transplantation. We are very concerned. We just have to pray that God will touch the politicians hearts from the house and the senate to quickly pass the bill to have Medicare extension for immunosuppressive drugs for kidney recipients. Thank God for the final rule of updating the Medicare payments to dialysis providers and increasing payments for home dialysis training! Now let’s remain hopeful and wait patiently for the immunosuppessive drugs final ruling.. .
I was in a similar situation after a kidney transplant in 1995. I would advise investigating a prescription assistance program option usually administrated through a local, or primary care clinic. Many clinics have an individual charged with assisting patients in the application process. As a backup plan at least. It worked for me after my super HMO refused to buy my immunosuppression drugs about six months post transplant. All drug manufacturers generously provided me with the drugs i needed…saved my life. No thanks to the HMO.
who or what determines length of time on dialysis?
Beware the transplant process for those in need and seeking placement on a transplant waiting list. I lost my transplanted kidney to malignancy after twelve years of excellent function. Required a complete nephrectomy and immediate return to hemodialysis. Was told by transplant staff I could receive another transplant after five years cancer free and that I would immediately be placed on a waiting list in inactive, or “hold” status but I would be accumulating my time towards the current average, or typical five year wait. Over the course of the five years and frequent contacts with transplant center, staff and multiple transplant coordinators I asked for and received confirmation of this status, and most importantly to me…the confirmation that I was immediately, from the time I resumed dialysis accumulating my waiting time on the list though not eligible for a transplant per the five year cancer free threshold. This was in Dec. 2007. Well I made my five years, which turned into six years per many consultations between medical staff and completion of tests requested by the transplant staff. Completed the tests and given green light by all involved, including oncologists, cardiologists and endocrinologist. Then I receive call from the latest transplant coordinator informing me I’ve now been placed on the active list with a waiting start date in 2010! WHAT!!! WHAT DO YOU MEAN 2010?! Every single person I’ve had contact with at the transplant center since Dec. 2007 has REPEATEDLY told me I was on the list since Dec. 2007 and accumulating my wait time. I asked repeatedly because obviously I was most concerned with this and was told repeatedly…every time I asked and by everyone I asked at the transplant center that yes, I was getting credit for my waiting time during the five years beginning Dec. 2007. Transplant coordinator says gee…I don’t know who told you that. Well I do…EVERYONE I spoke with over the last six years…numerous times. Now they tell me I’ll be waiting another 2-3 years. They screwed me out of the three years between 2007 and 2010 lying to my face and over the phone countless times during the past six years. I’m not likely to survive another three years on dialysis. Not really even willing to go through another three years of torturous thrice weekly treatments just to likely be told three years from now that no…you’ll have to wait another two years. My advice to anyone else in this position is to get every single word of consult with medical staff and especially the transplant staff recorded in some manner. Every name, date…EVERYTHING in black and white, on paper or recorded in audio media. video as well if possible. They LIED and refuse to acknowledge or admit it and there is little / nothing I can do about it. Hope everyone else in need has a better experience than me, survives and lives well.
Now going on eight years on waiting list. Eight years of in center hemodialysis. Dialysis that has now, and for the last two years become extremely painful. Excrutiating, constant pain in access arm during entire four hour treatments. Why eight years for me when average wait is five years? My recommendation to those in my area and needing a kidney is stay away from the University of Minnesota. Go to HCMC, United or Mayo.