Congress Passes Legislation to Help Dialysis Patients

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When Congress passed its comprehensive budget bill in February, it included important provisions that will improve telehealth options for people using home dialysis and reduce a backlog of clinics waiting for accreditation from the Centers for Medicare and Medicaid Services (CMS).

Dozens of new clinics across the country have been waiting for months, in some cases years, for government accreditation due to an outdated and overtaxed system that puts dialysis clinics as the lowest priority. Reaccreditation is also always prioritized over new clinics. Some states, including Hawaii, Kansas and Texas, have been waiting years for clinics to be approved because there are simply not enough inspectors to do the job.

“We have seen an increasing backlog of certifications that is simply not sustainable,” said Cameron Lynch, senior vice president of government affairs for Fresenius Medical Care North America (FMCNA). “Clinics would be built and then wait a year or two before they were surveyed. They just sat there empty. Patients couldn’t go there, and employees couldn’t work there. This became a top priority to ease this burden.”

In February, Congress passed the Dialysis Access Improvement Act of 2017, which will finally allow independent quality assurance organizations to issue accreditation. While hospitals have long used outside accreditors, dialysis providers were the only Medicare providers prevented from enlisting independent organizations for these inspections.

This new legislation levels the playing field and allows dialysis providers to cut through this regulatory red tape in the best interest of patients. At the same time, CMS is pushing forward with their own plan to address the backlog with priority surveys, identifying dozens of clinics across the country that have waited more than a year.

In the same Bipartisan Budget Act, Congress included significant portions of the Chronic Care Act of 2017, which will expand telemedicine options for patients on home dialysis starting in 2019. While the bill addressed many areas of chronic disease management and care, it greatly expands telehealth within certain Medicare Advantage plans. And starting next year, Medicare will pay when home dialysis patients use telehealth services to connect with their nephrologist for monthly assessments.

“This is an important step in the right direction and will allow us to expand our patient-centric approach to care,” said Dr. Ahmad Sharif, chief medical information officer for FMCNA. “Telemedicine has the potential to provide better access to care for our patients at the time of their convenience and when they need it. We are actively working to explore more telehealth options, especially for our home dialysis patients and patients in remote areas.”

Despite the acceleration of new technologies to improve care for dialysis patients, the growth of telemedicine has been hampered in recent years because of limited options for Medicare reimbursement. The new legislation will likely help accelerate the adoption of telehealth and could help push private insurance to also reimburse providers for using this important technology. And the increasing focus on value based models of care could usher in wider adoption of this important technology as part of the shared goal to improve satisfaction and health outcomes for all patients.