Dialysis Medicare Legislation

December 15, 2000 - The lame-duck 106th Congress has finally passed the budget for the next fiscal year.

Here is a short summary of the increased Medicare benefits included in this just passed legislation.

While the final versions of these bills have not yet been released, they are expected to include several spending increases that will benefit End-Stage Renal Disease (ESRD) care. Among these are:

Increase in the composite rate and funding for a HCFA study to develop an annual inflation formula for the composite rate.

Coverage of Medical Nutritional Therapy Services for Beneficiaries with Diabetes or a Renal Disease

Elimination of Time Limitation on Medicare Benefits for Immunosuppressive Drugs. This will eliminate the time limitation on Medicare coverage of immunosuppressive medications for transplant recipients who are eligible for Medicare based on age or disability. Kidney transplant recipients whose Medicare eligibility is based solely on their End Stage Renal Disease do not qualify for the extended benefit period.

More details will be available later !!

December 13, 2000 - The American Hospital Association reports that congressional leaders and President Clinton reached a tentative agreement late Monday for a plan that adds $2.7 billion to the Medicare, Medicaid, and SCHIP Benefits Improvement Act of 2000 (BIPA).

Here is the latest news summary on the still-pending budget issues.

December 12, 2000 - Here is the status of the budget negotiations between Clinton and Congress as of 2AM this morning.

December 11, 2000 - The Balanced Budget Act (BBA) relief package may be passed this week by Congress. Here is the latest summary from the American Hospital Association.

Here is another summary of the bill's status from Modern Healthcare.

December 9, 2000 - Congressional leaders and the White House are now optimistic that the Balanced Budget Act relief bill can be passed by the end of next week.

Here is a summary of the lame-duck budget battle as of Friday evening, December 8th.

December 8, 2000 - The Republican congressional leadership is reported to be considering attaching the Medicare relief package to the Labor/Education/Health appropriations bill.

Here is the latest story on the budget battle between Congress and President Clinton.

December 7, 2000 - House Majority Whip Rep. Tom Delay, R-TX, dampened optimism that existed for passing a Medicare relief bill by stating that if President Clinton does not sign Republican-favored legislation, the government may be shut down.

On a positive note, a bipartisan forum of senators urged passage of the Medicare relief bill.

December 6, 2000 - Congress returned to work yesterday and many expressed positive statements and guarded optimism concerning the passage of the Medicare relief bill.

Here is a summary of the first day of the lame-duck session.

December 5, 2000 - A lame-duck Congress returns to work today with the Medicare relief bill likely to be part of the struggle between Clinton and the congressional Republicans.

December 1, 2000 - With Congress due to begin a lame duck session on December 5, legislators will first have to pass a funding resolution to keep the government operating.

With the presidential election stalemate, there are now rumors about removing the 1997 Balanced Budget Act Medicare relief bill from the omnibus tax measure and affixing it to a four-month funding resolution.

November 23, 2000 - A group of 23 Republican senators has written Senate Majority Leader Trent Lott, asking him to remove the Balanced Budget Act relief package from the stalled tax bill (H.R. 2614) inorder to improve its likelihood of being passed this session.

November 22, 2000 - Sens. Phil Gramm, R-TX, and Sam Roberts, R-KS, are urging that the Medicare measure be stripped from the tax bill before Congress and be passed separately as soon as possible.

November 21, 2000 - Congress will resume its current session on December 5th.

Hospitals and insurance companies are now working together to urge Congress to pass the Medicare Balanced Budget Act relief package before this session adjourns.

Several key congressional healthcare advocates lost their elections this year, putting the status of several key pieces of legislation in limbo.

November 10, 2000 - Reported by Gwen Gampel, NRAA Government Relations Consultant

With all of the uncertainty in Washington as a result of the elections, the NRAA is very concerned that the lame-duck session of Congress will be too preoccupied to pass the Medicare give back bill. This bill is loaded with important reimbursement issues for dialysis facilities including a 2.4% increase in the composite rate, worth $500 million over five years, a moratorium on HCFA reducing the average wholesale prices of ESRD related drugs, nutritional therapy services for renal patients, a HCFA study on developing an annual inflation formula for the composite rate and elimination of the time limitation on immunosuppressive drug coverage.

Therefore, we urgently need all ESRD community members to write their U.S. Representatives and Senators urging them to pass H.R. 2614, the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000.

The lame-duck session of Congress begins November 13 so letters need to be sent as soon as possible. You can also e-mail members of House of Representatives at www.house.gov/writerep, the Senate at www.senate.gov/contacting/index.cfm, or contact them by phone through the central switchboard at (202) 224-3121. A sample letter in two common word processing formats are provided below:

• WORD® document (doc) - sample letter to Senator or Representative
  
• Rich text format (rtf) - sample letter to Senator or Representative

November 8, 2000 - The status of the Balanced Budget Act (BBA) relief package has been thrown into confusion by the election results. Several legislators who have been leaders in crafting healthcare legislation have lost their elections:

Delaware Republican Senate Finance Committee Chairman William Roth, chief proponent of his committee's Medicare relief package, has lost to Thomas Carper.

Another Finance Committee member, Virginia Democratic Senator Chuck Robb, has lost to George Allen.

Missouri Republican Senator John Ashcroft, who wrote the Senate-passed Medicare and Social Security lock-box legislation, has lost to deceased Democrat Gov. Mel Carnahan, whose widow will serve in the Senate.

The Michigan Republican Senator, Spencer Abraham, a long-time health provider advocate and key member of the Budget Committee, has lost to Debbie Stabenow.

Hillary Clinton, who is likely to have an interest in healthcare legislation, won a Senate seat in New York.

With the Republicans retaining control of the House of Representatives, two fellow Ways and Means Republican members, health subcommittee chairman William Thomas (CA) and Phillip Crane (IL), are both looking to replace retiring Rep. Bill Archer as full committee chair.

Rep. Karen Thurman (D-FL), who is active in ESRD issues, won reelection with 64% of the vote.

November 7, 2000 - Modern Healthcare magazine reports that hospital lobbyists are afraid of a lame-duck Congress won't feel any pressure to pass Medicare provider pay hikes.

Here is a report from the American Hospital Association on status of the Medicare legislation.

November 2, 2000 - Here is the House of Representatives version (HR 5433) of the Balanced Budget Act (BBA) relief package. It is a 307 page pdf file.

See the following sections for ESRD-related services:

Section 105 - renal nutrition (pg 17)

Section 113 - immunosuppressant drugs coverage (pg 23)

Section 422 - dialysis composite rate (pg 136)

November 1, 2000 - It appears that the battle over the budget, including the efforts to increase Medicare reimbursements for dialysis providers, will not be resolved until after next week's election.

October 31, 2000 - Here is a summary of the budget battle and the status of Medicare funding legislation from the American Hospital Association.

The Coalition to Protect America's Health Care (web site) launched a new TV ad on Monday that urges bipartisan action to resolve the stalemate between Clinton and Congress. The ad will run through Wednesday in the Washington area only.

The Coalition has also released a summary entitled, Balanced Budget Act Relief: What's At Stake. The summary states, "The composite rate payment for renal dialysis services would be increased by 2.4 percent for 2001. HHS is required to collect data and develop an end-stage renal disease (ESRD) market basket index."

October 30, 2000 - Here is the latest budget battle story (Oct 30, 1:52pm).

White House and congressional negotiators worked over the weekend (Reuters) and into early Monday morning trying to reach a compromise on a budget package, which includes Medicare reimbursement increases for dialysis providers.

Here is another report on the weekend negotiations from the Associated Press writer.

October 28, 2000 - The Medicare reimbursement increases for dialysis providers have become part of the election-year budget showdown in Washington. The dialysis reimbursement increases are part of a Balanced Budget Act (BBA) relief package which is wrapped into legislation providing assistance to HMOs. That bill in turn is part of the Taxpayer Relief Act of 2000, which contains small business tax relief, immigration, school construction provisions and other measures. Democrats contend that the tax bill is skewed toward the rich and powerful and President Clinton has threatened to veto the entire package.

Here are the latest stories on the issue:

Democrats Decry Tax Cuts, Wage Hike from AP/Yahoo

Businesses Poised To Benefit From Bills from the Washington Post

BBA relief held captive in Pennsylvania Avenue showdown from AHA News

October 27, 2000 - Here's the latest report (1:20 pm, Fri, Oct 27) on the status of the Medicare legislation in Congress.

October 26, 2000 - It appears that the Medicare legislation, with its increases for dialysis providers, has become an election issue and may be vetoed by President Clinton.

Here is another viewpoint of the story from Bloomberg Financial News.

October 25, 2000 - Here is a summary of the Medicare legislation status as of 8:58 pm on October 25th.

The AHA reports that President Clinton is offering a compromise to the Republican leadership in Congress on the budget involving Medicare reimbursement.

October 24, 2000 - The American Hospital Association (AHA) reports that talks continue on the Medicare relief package, but no decision has been reached.

October 23, 2000 - Here is the latest report from the American Hospital Association (AHA) on the progress of the 1997 Balanced Budget Act (BBA) Medicare relief package in Congress. The current package is reported to included increases for dialysis providers.

According to the AHA News, "Lawmakers have until Wednesday, when the current continuing resolution keeping the government funded expires, to resolve the matter."

October 20, 2000 - With the current session winding down, Congress finally appears ready to pass Republican-sponsored legislation that would increase reimbursement for Medicare providers. Importantly, it would raise Medicare payments for kidney dialysis providers by 2.4 percent. Unfortunately, President Clinton has threatened to veto this version because it includes large reimbursement increases to HMOs. Here are three views on this story:

Republicans outline Medicare plan from Reuters/Yahoo

Republican Lawmakers Introduce $28 Billion Medicare Bill from Bloomberg Financial News

Leaders Seek Compromise on Medicare

September 14, 2000 - As you may know, Medicare payments for dialysis treatments have been essentially stagnant since 1983. This has forced dialysis centers to constantly seek ways to become more cost-efficient. At this point, nearly everyone agrees that no further productivity gains can be realistically expected.

At long last, legislation has been introduced in Congress to rectify this situation and to provide dialysis centers with an annual inflationary adjustment. The bill has been assigned number S. 3038 in the Senate and H.R. 5152 in the House of Representatives.

Here is the language of the "Medicare Renal Dialysis Payment Fairness Act of 2000" bill that was introduced in both the House and Senate on September 12.

Here is a list of senators and representatives that are sponsoring this bill.

Congress will not enact this legislation unless it receives sufficient evidence of grass roots support for this increase in federal spending. Therefore, it is very important that everyone writes their Senators and Representative in support of this legislation.

The National Renal Administrators Association (NRAA) has sample letters in support of this legislation that dialysis professionals can send to their congressional representatives.

Sample letters for dialysis patients are provided below which can be sent to congressional representatives. These are word processing documents that you can edit, save, and print on your own computer.

WORD™ (doc) sample letter to US Senator
Rich text format (rtf) sample letter to US Senator

WORD™ (doc) sample letter to US Representative
Rich text format (rtf) sample letter to US Representative

Click here to access a list of addresses for U.S. Senators and Representatives arranged by state.

It's easy to send an e-mail. All the senators have e-mail addresses listed, so simply edit the above letter, copy it, and then paste the contents into an e-mail to each of your state's senators. The House of Representatives has an e-mail writing service that helps you locate your representative and delivers your message to him/her.