As healthcare consumers, we have an important need to know how pending legislation could affect our care. And as Medicare beneficiaries, we have an even more important need to know how legislation or payer changes could affect what services, treatment options and medications, etc. are available to us. AAKP has numerous resources that can help you stay informed such as this magazine; our web site at www.aakp.org; two different electronic newsletters - AAKP Kidney Beginnings and AAKP Renal Flash; or by calling our office directly. Below is a brief synopsis of the issues currently affecting renal patients.

Centers for Medicare and Medicaid Services

As many of you know, the Health Care Financing Administration (HCFA) has changed its name to the Centers for Medicare and Medicaid Services (CMS). Not only was the name changed this past summer, but the agency is also in the midst of being restructured. The positive outcome of the restructuring is that the Secretary of Health and Human Services, Tommy Thompson, plans to make the agency more beneficiary friendly by being more responsive and improving the quality of care beneficiaries receive. The agency is being restructured around three so-called centers.

The Center for Medicare Management: This center will deal with management of the traditional fee-for-service Medicare program. This includes payment issues.

The Center for Beneficiary Choices: This center will provide beneficiaries with information on Medicare, Medicare Select, Medicare+Choice and Medigap options. This center will also deal with quality and grievance issues.

The Center for Medicaid and State Operations: This center will deal primarily with programs administered by states, such as Medicaid.

To achieve the goals outlined above, the Centers for Medicare and Medicaid Services (CMS) will launch a national media campaign to give beneficiaries more information to help them make decisions about how they want to receive their healthcare.

It is unclear how these changes will affect the Medicare ESRD Program or ESRD patients.

AAKP Releases Updated Statement on Daily/Nocturnal Dialysis

In response to the development of two new ways to provide hemodialysis, daily short dialysis and slow nocturnal dialysis, AAKP has released the following policy statement. This replaces any previous daily/nocturnal policy statements released by AAKP.

The American Association of Kidney Patients (AAKP) in keeping with its mission to help all kidney patients, continues to encourage the improvement of existing treatment options and the development of new treatment methods, which will result in improved quality of care and clinical outcomes for kidney patients.

Currently, some new treatment options are being investigated, such as altering the frequency and duration of hemodialysis treatments. AAKP strongly encourages that all new options be verified as medically effective, safe and yield better health outcome results, as recognized by the U.S. Food and Drug Administration (FDA), National Institutes of Health and/or other required institutions and that such options be appropriate for the particular patient as determined by the physician and patient.

AAKP urges the payers and providers to develop mutually agreeable economic arrangements for all FDA approved therapies.

AAKP strongly believes that the physician and patient should work together to select the best treatment for that individual patient; and that this decision should be supported by policies and practices which ensure equal access to the most effective therapy.

Medicare Dialysis Benefit Improvement Act of 2001

Reps. Dave Camp (R-MI) and Karen Thurman (D-FL) introduced legislation to increase the composite rate (the cost reimbursed to facilities for your dialysis treatments) by 2.6% for calendar year (CY) 2002 as well as provide reimbursement for a routine fourth hemodialysis treatment for patients who require more than three treatments per week.

At the time of this writing, there was not a companion bill in the U.S. Senate. The only way this bill could become law is if it is incorporated into a broader Medicare reform/prescription drug bill.

The American Association of Kidney Patients does not normally respond to provider payment issues or proposed composite rate increases without additional information as to how any proposed composite increase rate increase would directly affect patients' health outcomes and quality of care. AAKP wants to ensure that a composite rate increase would be used specifically to address the needs of patients such as increased values for Kt/V and other clinical outcomes.

The American Nephrology Nurses Association (ANNA), the National Kidney Foundation (NKF), the National Renal Administrators, the Renal Physicians Association and others have joined together to urge members of Congress to cosponsor H.R. 2220. The group cited the need for an increase in a letter stating, "Like every other health care provider, dialysis facilities are facing the same staffing shortages and are having to pay bonuses and premium wages in order to attract qualified nurses, patient care technicians, dietitians and social workers. Dialysis facilities will also have to absorb two increases in an anemia management drug, provided to 90 percent of patients, even though Medicare's reimbursement for this drug is capped."

Washington Report, aakpRENALIFE, Vol. 17, No. 2, Special Edition 2001

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