The payment adjustment will affect 85% of the estimated 450,000 dialysis patients. In the United States there are 5,869 profit and non-profit dialysis centers, including 780 hospital-based centers, according to the U.S. Renal Data System.
Congress seems willing to engage in the effort. A bipartisan group of senators led by Sen. Ben Cardin (D-MD) and Sen. Mike Crapo (R-ID) expressed concern in a May 17 letter that if CMS "does not exercise caution (which it has the statutory authority to do), the adjustment could threaten the improvements made to the Medicare ERSD program and jeopardize beneficiary access to care."
In a letter dated May 28, the House Ways and Means Committee's Health subcommittee chair, Rep. Kevin Brady (R-TX) and Jim McDermott (D-WA), the subcommittee ranking member, asked to be kept apprised of CMS actions. "We are specifically interested in the rulemaking that the agency is undertaking to implement the ATRA provisions."
CMS is expected to propose ESRD rules by the end of June. One kidney care advocate says the "effort right now is to make our case…to see if there's a way to get the proposed rule to be closer to what we want. It's just easier if you get it right in the proposed rule."