H.R. 6214: Kidney Care Access Protection Act

This bill, known as the Kidney Care Access Protection Act, aims to enhance the accessibility and quality of kidney care treatments for individuals with end-stage renal disease (ESRD) under the Medicare program. It outlines several key provisions which can be categorized into three main titles:

Title I: Protecting Patient Access to Kidney Care Innovation

• Refining the ESRD Payment System: The bill extends the Transitional Drug Add-On Payment Adjustment (TDAPA) period for new renal dialysis drugs for at least three years from their approval date, ensuring that innovative treatments remain accessible. The bill also establishes a permanent adjustment for payments related to these new drugs starting January 1, 2026.
• Clarifying Definitions: It redefines renal dialysis services to focus on specific care without including drugs for unrelated comorbid conditions, ensuring that innovative therapies specifically targeting ESRD are prioritized.
• Support for New Equipment: The bill allows for transitional payment adjustments for new renal dialysis devices and ensures that breakthrough devices receive similar support starting in 2026.

Title II: Addressing Staffing Barriers with ESRD Market Basket Labor Adjustments

• Improving Payment Stability: It requires adjustments to the annual payment amounts for kidney care services to account for errors in forecasting growth, providing better financial stability for service providers.

Title III: Preventing Kidney Disease and Expanding Awareness and Education

• Kidney Disease Screening: The bill expands annual Medicare wellness benefits to include screenings for chronic kidney disease, encouraging early detection and intervention.
• Increasing Access to Education: It enhances access to kidney disease education benefits, enabling facilities to provide necessary education on managing the disease.

The provisions outlined in the bill are set to go into effect on January 1, 2026, for items and services furnished on or after that date.

Relevant Companies

• DVA (DaVita Inc.) - This company, which operates dialysis centers, may see changes in payment structures and patient volumes due to adjustments in Medicare payments for kidney care.
• FMS (Fresenius Medical Care AG & Co. KGaA) - As a leader in renal care and dialysis products, Fresenius could be significantly impacted by the expanded Medicare benefits for new treatments and devices.