We are just a quarter into the new century and already it looks like a slow legislative year, not only for kidney patients, but for all Americans.

The year 2000 began not with a bang in DC, but rather with a quiet whimper.  With a “lame duck” president, Gore on the campaign trail, both the Senate and House up for election, we can expect little or nothing in the form of legislation this year.  Certainly, Medicare legislation will not be a moving issue because of legislators' concern of losing votes at home.

However, there will be some regulatory issues – how passed laws are interpreted and put into effect – this year.

Release of facility specific data

The ESRD Stakeholders Council convened by the Health Care Financing Administration (HCFA) is in the final phase of preparing to release statistics to the general public.  AAKP is well represented on this working committee and every effort is being made by the Association to ensure patients receive accurate information about dialysis facilities that they can use in a decision making process.  The purpose of this Council is to assist HCFA in deciding what data will be released to 1.) the general public and 2.) the state surveyors to assist with facility audits.  This project is mandated by the 1997 Balanced Budget Act and requires HCFA to provide Congress with a method for assessing the quality of dialysis care delivered to ESRD Medicare beneficiaries. Data reporting and dissemination will begin this year.  This project will enable you to access information about the delivery of care in all dialysis facilities throughout the U.S.

Managed Care

The Medicare Payment Advisory Commission (MedPAC) has held meetings in the past few months to see how payment reform in the ESRD program relates to managed care. This Commission is responsible for advising Congress on Medicare payment issues. In a recent review by MedPAC staff the lifting of the bar prohibiting ESRD patients from enrolling in managed care plans was discussed. The recommendation MedPAC will most likely suggest to Congress is that the managed care prohibition not be lifted until revisions in the payment and quality oversight programs are in place.

MedPAC will likely recommend on March 15 that HCFA should risk adjust payments using all available data for ESRD patients enrolled in Medicare + Choice. This means that payment would take such things as age, comorbid conditions and other factors into account.

AAKP has continued to be adamant about the concern for patients enrolling in HMO’s, given the life-sustaining nature of dialysis treatments and transplantation.  In 1999, AAKP released its statement to members of Congress, HCFA and most recently to MedPAC. (The statement appears in aakpRENALIFE Volume 15, #3.)

The AAKP Renal Flash, AAKP’s monthly electronic newsletter, keeps you updated on the most recent legislative and regulatory initiatives that affect renal patients.  You can subscribe by visiting our web site at www.aakp.org.

Washington Report, aakpRENALIFE, Vol. 15, No. 4, March 2000

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