There are several bills related to kidney disease in Congress this year, however due to unexpected high-priority issues such as homeland security, little if any enactment is expected.   Congress will adjourn in November for the year. Any bills not passed by then will "die" and have to be re-introduced in a future Congress. It is important to understand the difference between a new Congress and a new legislative session. A new Congress begins every two years (in this case that was 2001) and corresponds with the election cycle of the House of Representatives. A legislative session occurs every calendar year so there are two sessions to each Congress Ð a first session that begins around January (in this case 2001) following a Congressional election cycle until the following November or December, and then a second session that begins the following January (in this case 2002) until the next November (2002), when another election is held. Legislation that fails to become law prior to the end of a Congress has to be re-introduced in the new Congress.

The following bills are of particular interest to kidney patients and the renal community. A bill must be introduced in both the House and Senate if it is expected to become legislation. These are known as "companion" bills. A bill also needs to be "scored" by the Congressional Budget Office (CBO) so that Congress knows how expensive it will be for taxpayers.

H.R. 2220 and S.1605 - These are companion bills to increase the composite rate paid to facilities for calendar year 2002 and provide payment for a routine fourth dialysis treatment per week for those patients who need it.   The price tag of the bill is steep as the Congressional Budget Office (CBO) scored the cost to Medicare at over $400 million over five years and $1.4 billion over 10 years.   The fourth treatment is not a request for daily dialysis (see bills below) but instead a treatment of medical necessity for patients who may require extra dialysis because of certain conditions such as excessive weight, fluid overload, etc.

H.R. 1759 and S.1303 - These are the companion bills to provide payment for more frequent hemodialysis, known as daily or nocturnal dialysis.   These two bills gained cosponsors throughout the first session, but hit a snag when the CBO estimated that the bill would cost $300 million over five years. Though this estimation was lower than expected, it is still high enough to raise concern by members of Congress when America no longer has a budget surplus and the nation is in a recession.

H.R.3246 and S.1304 - These companion bills would provide Medicare coverage of oral drugs to reduce serum phosphate levels in ESRD patients.   As of this writing, there still is not a score by the CBO, which is needed before the bill can move forward. Currently, Medicare does not cover oral medications for beneficiaries.

AAKP will keep you updated on the progress of these bills. One of the best ways to find out current legislative and regulatory information is to subscribe to the AAKP Renal Flash, our monthly Internet newsletter. You can do so by sending an e-mail to info@aakp.org or by visiting our web site at www.aakp.org.

Washington Report, aakpRENALIFE, Vol. 17, No. 6, May 2002

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