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Bipartisan Legislation Built With Quality Patient Care in Mind | Commentary

Although Americans might struggle to find consensus on many policy issues related to health care, when faced with a serious health issue we unite behind the common goal of helping those living with it. Policymakers, health officials and the public have thrown their muscle behind putting a stop to once-deadly childhood illnesses, harmful toxins, and other threats to our health and safety.

Now the kidney community is doing the same — standing together to improve the outlook for Americans with Chronic Kidney Disease and for those who have kidney failure. Our nation’s leading kidney patient advocacy groups are proud to support H.R. 4814 —The Chronic Kidney Disease Improvement in Research and Treatment Act of 2014.

CKD, a slow and often silent, progressive condition, damages the kidney’s ability to cleanse the body of waste products. More than 26 million Americans have CKD and another 1 in 3 is at risk. When CKD is not recognized and treated, it can progress to irreversible kidney failure, or End Stage Renal Disease. Kidney failure affects more than 615,000 Americans and is survivable only with a kidney transplant or life-sustaining dialysis treatments that cleanse the blood several times per week.

Increases in risk factors for CKD and ESRD — including high blood pressure, diabetes and obesity — have led to an increased urgency for new approaches in prevention and treatment. The Chronic Kidney Disease Improvement in Research and Treatment Act of 2014 addresses this problem from multiple angles and seeks to ensure that Americans living with kidney disease have access to the health care necessary to survive and thrive.

H.R. 4814 addresses gaps in critical research by requiring the Department of Health and Human Services to evaluate federal spending on kidney disease research compared to that on kidney disease treatment; improve coordination of Federal research efforts across agencies; and investigate the differences in disease progression and treatment patterns in minority populations which are disproportionately impacted by the disease. The bill also improves access to care for Medicare beneficiaries with CKD. It removes barriers to patients receiving the Medicare Kidney Disease Education program, which helps patients make informed decisions about dialysis options, including home dialysis, getting on the transplant waiting list, and steps to take towards identifying a living kidney donor. H.R. 4814 also provides incentives to nephrologists and other non-physician health professionals to practice in underserved rural and urban areas to improve access to care.

Another provision of H.R. 4814 will allow individuals with temporary kidney failure — known as acute kidney failure — to receive treatments through dialysis facilities instead of being restricted to obtaining treatment through more expensive hospital outpatient departments, which are not always located near patients’ homes. The legislation also expands coverage options for beneficiaries with kidney failure by allowing them to maintain their private insurance longer and providing access to additional Medicare program options. Under current law, patients with kidney failure are required to relinquish their private insurance coverage after 30 months and join Medicare, which can result in more restrictive choice of providers or loss of certain benefits like maternity care or family coverage. Further, the legislation allows ESRD patients greater choice in care offerings, including enrolling in Medicare Advantage plans and participating in a new coordinated care program.

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