Legislative Update – Transplantation

Medicare immunosuppressive coverage extension.

As Transplant Chronicles readers are aware, eliminating Medicare’s current limit on immunosuppressive drug coverage, 36 months post-transplant for kidney patients who are not aged or disabled, is a top NKF legislative priority. We coordinate a coalition of kidney and transplant organizations to work towards this goal and have helped build broad recognition and support in Congress for the legislation. In the last Congress, the House and Senate legislation secured 129 and 21 cosponsors, respectively. Unfortunately, very few Medicare bills were passed last year. However, Sens. Durbin (D-IL) and Cochran (R-MS) introduced S. 323 on February 13, 2013 to provide lifetime Medicare coverage of these essential medications, and Reps. Burgess (R-TX) and Kind (D-WI) plan to introduce the bill in the House as well.

Please contact your Senators today through our TAKE ACTION NETWORK to tell them how this important bill would impact you.

Expanding the availability of organs for transplantation.

The National Kidney Foundation has been working with Rep. Nadler’s (D-NY) office for several months to draft legislation to protect living organ donors from various forms of discrimination, including the availability and affordability of life insurance and disability insurance. The bill also would require establishing a system to collect and disseminate data on the long-term impact of living organ donation. Rep. Nadler expects to introduce legislation soon.

Legislation was introduced by Rep. Kissell (D-NC) in the 112th Congress to provide a federal income tax credit of up to $10,000 to help offset out-of-pocket, non-medical expenses, lost wages, and other financial barriers associated with living donation. However, Rep. Kissell was defeated in November. We do not know if another Representative will take up the cause, but we will have a conversation with a member of the Ways & Means Committee to ascertain his interest.

Assuring that the Affordable Care Act meets the needs of people with chronic kidney disease.

Health Insurance Exchanges created by the Affordable Care Act (ACA) will be open for enrollment this fall and are effective January 1, 2014. NKF’s activities will include ensuring (a) the Essential Health Benefits under insurance exchanges provide for early identification and treatment of CKD, (b) adequate payment is made for all modalities of kidney replacement therapy, including transplantation and home dialysis, through insurance available from an Exchange, and (c) support is available from the new Prevention and Public Health Fund for wellness programs focused on CKD. We will also ensure that kidney patients under the expanded Medicaid have similar protections (many states have opted to participate in the expanded Medicaid eligibility under the ACA, which the U.S. Supreme Court ruled is not mandatory). Examples of our efforts include submitting comments to federal agencies in response to proposed rulemakings and meetings with federal agency staff.