More than 50 members of the House of Representatives, including five from districts in New York State, have cosponsored the Restore Protections for Dialysis Patients Act. The bipartisan legislation (H.R. 6860) is intended to protect private insurance coverage for people with end stage renal disease, also called kidney failure.
"This legislation is critical for Americans living with End Stage Renal Disease and who rely on dialysis," Rep. Mike Kelly of Pennsylvania said in introducing the act. "Patients deserve to know their benefits will be in place when they need them. This legislation will improve both patient care and patient outcomes.”
The Kidney Foundation of Western New York has joined the American Society of Nephrology, American Kidney Fund, American Nephrology Nurses Association and other health organizations in calling for Congress to pass the act.
In the early 1980s, Congress passed the Medicare Secondary Payer Act to protect the private health insurance coverage of people with end stage renal disease and also limit the expenses to the Medicare Trust Fund. Until recently, people who qualified for Medicare due to end stage renal disease could retain their private coverage for 30 months. During that time, the primary responsibility for medical costs stayed with the private insurer, with Medicare designated as a secondary payer.
The U.S. Supreme Court’s decision in Marietta v. DaVita (2022) allows insurance companies to limit coverage of kidney care services, including dialysis.
A bipartisan group in Congress introduced the Restore Protections for Dialysis Patients Act in December 2023. If passed, the act would restore Medicare Secondary Payer Act protections for ESRD patients by ensuring that private health plans do not discriminate against such patients or adversely classify dialysis as compared to other covered medical services.
“The Restore Protections for Dialysis Patients Act will protect people receiving dialysis access to private insurance and mitigate the most drastic consequences of a 2022 Supreme Court decision,” American Society of Nephrology President Michelle A. Josephson, MD, FASN, said in a news release. “These potential impacts include loss of coverage of critical services and medications provided through employer plans and loss of coverage for family members upon kidney failure diagnosis.”
“Private insurance can be vital to patients’ access to care and plays a critical role in ensuring the stability of the Medicare system,” Keith A. Bellovich, DO, president of the Renal Physicians Association, said in a 2023 news release. “I urge House lawmakers to swiftly advance this legislation, which will make a meaningful difference for the more than 800,000 patients living with kidney failure.”
Several organizations have created sample letters and templates for advocates to contact their elected officials:
The American Kidney Fund has a template for emailing members of Congress at https://www.kidneyfund.org/action/ask-your-representative-cosponsor-restore-protections-dialysis-patients-act-hr-6860.
Dialysis Patient Citizens has a template for contacting Congressional representatives at https://kidneyaction.org/esrd/.
Nephrology nurses can submit a letter through ANNA at https://www.annanurse.org/action-center?vvsrc=/Campaigns/116133/Respond
Track the act’s progress in the House at https://www.congress.gov/bill/118th-congress/house-bill/6860/all-actions and in the Senate at https://www.congress.gov/bill/118th-congress/senate-bill/5018/all-actions.
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