NKF Speaks Up for Patients in CMS’s 2026 Dialysis Payment Rule

When Medicare updates how it pays for dialysis, the changes impact every person on treatment and their loved ones. That’s why the National Kidney Foundation (NKF) submitted detailed comments to the Centers for Medicare & Medicaid Services (CMS) on the Calendar Year 2026 End-Stage Renal Disease Prospective Payment System (CY2026 ESRD PPS).

In our letter, NKF urged CMS to keep patients at the center of care, protect access for people on dialysis, and support innovations that improve quality of life.

• Protecting Patient Access and Quality Care
• Supporting Innovation Without Leaving Patients Behind
• Expanding Home Dialysis, Patient Education, and Nutrition Support
• Looking Ahead
• ✅ Top 3 Takeaways

Dialysis facilities, especially small and rural clinics, face rising costs, including staffing shortages and higher labor expenses. NKF encouraged CMS to adopt policies that help clinics hire and retain skilled professionals who make dialysis safe, effective, and compassionate.

We also urged CMS to preserve health equity and social drivers of health measures. 

These standards hold clinics accountable for addressing barriers like:

• Transportation
• Housing instability
• Food insecurity

These issues directly affect whether patients can get to treatment and stay healthy.

Learn more about NKF's regulatory advocacy. 

Dialysis care has advanced. New medications and technologies are available, but payment policies have not always kept pace. Smaller and independent clinics often struggle to access these innovations, delaying care for patients.

NKF asked CMS to revisit how new technology is evaluated so that breakthrough tools reach patients faster.

Home dialysis can provide greater flexibility and improve quality of life. Yet barriers limit who can access it. 

NKF, alongside the Alliance for Home Dialysis, urged CMS to:

• Remove obstacles to home dialysis so more patients can choose this option.
• Expand access to Kidney Disease Education (KDE) to help people understand all treatment choices.

Tell your legislator to support the Improving Access to Home Dialysis Act.

Nutrition is also critical for kidney health. NKF called for:

• Better access to Medical Nutrition Therapy (MNT) for personalized counseling with a registered dietitian to manage kidney disease, blood pressure, and blood sugar.
• New quality measures that reflect the role of nutrition in improving outcomes.

Sign our petition to the FDA to add phosphorus to food labels.

People living with kidney disease deserve a payment system that values quality, equity, and innovation. NKF will continue to advocate so every patient and family gets the care and choices they need.

Ready to raise your voice to improve the lives of people with kidney disease? Become an NKF Voices for Kidney Health advocate today.