Immunosuppressive drug legislation

The Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019 (H.R.5534 / S.3353) would extend Medicare coverage for immunosuppressive drugs by removing the current three-year limit for transplant recipients under the age of 65 who are Medicare-eligible because of their end stage renal disease (ESRD). AKF and our Ambassadors have met with congressional offices throughout the year to gain support for this legislation, and our focus now is to have it included in an end-of-year legislative package.

Ensuring that transplant patients have continued access to the immunosuppressive drugs that prevent their bodies from rejecting their new kidneys is critical to keeping them off dialysis. This is especially crucial during the COVID-19 pandemic because it is important for vulnerable transplant recipients to stay home and avoid as much contact with others as possible. Also, with millions of Americans now facing unemployment and possible loss of health insurance as a result of the pandemic, extending Medicare coverage of immunosuppressive drugs is even more essential.

Take action: Please take two minutes and ask your representative and senators to support this legislation by sending a message through our website. Your voice matters!

Medicare Advantage and ESRD

With the Medicare open enrollment period currently underway (October 15 – December 7), Medicare Advantage (MA) is now a coverage option available for all Medicare ESRD beneficiaries, starting with the 2021 plan year.

As we described in a March blog post, deciding between traditional Medicare and Medicare Advantage requires someone with ESRD to carefully weigh a lot of important factors, and everyone's personal and financial situation is different.

ESRD beneficiaries should also be aware that in a final regulation released in May, the Centers for Medicare and Medicaid Services removed outpatient dialysis from its list of specialty facilities that are subject to MA network adequacy standards. These standards determine how many types of providers must be in a plan's network, based on factors like travel time or the number of miles a beneficiary must drive to reach a provider's office or facility.

More information on this issue can be found in our September blog post. As ESRD beneficiaries consider their Medicare options during open enrollment, they should understand which outpatient dialysis providers may or may not be within an MA plan's network.

Trump administration finalizes rules as part of Advancing American Kidney Health initiative

The Trump administration recently released final rules that aim to encourage greater use of home dialysis and transplantation among Medicare beneficiaries and remove financial barriers to living organ donation. These final rules are part of the administration's Advancing American Kidney Health initiative, which was launched last year with three main objectives: increase efforts to prevent, detect and slow the progression of kidney disease; provide kidney disease patients with more options for treatment; and deliver more organs for transplant.

Read our blog post summarizing the final rules.