January 22, 2026
On Wednesday, January 8, 2026, the House Energy & Commerce Committee held a hearing on 10 bills aimed at improving Medicare payment policies and patient access. None are kidney-specific—but that doesn’t mean they won’t affect you.
Here’s what’s on the table and why it matters for the kidney community.
H.R. 6361: Stopping AI from Denying Your Care
What it does: The “Ban AI Denials in Medicare Act” would prohibit Medicare from using artificial intelligence algorithms to deny or delay care through prior authorization.
Why it matters: Insurance denials are getting worse as more insurers use AI for coverage decisions.
For transplant recipients: The American Society of Transplantation has documented that patients relying on Medicare Part D face denials for immunosuppressant medications—sometimes “upheld through multiple levels of appeal.” When patients can’t get anti-rejection drugs covered, they may ration or stop taking them, putting their transplant at risk.
A CBS News investigation reported on a lawsuit alleging UnitedHealthcare used an AI tool with a 90% error rate to deny care to elderly Medicare Advantage patients. And an AMA survey found 61% of physicians believe AI is increasing denials and “exacerbating avoidable patient harms.”
This bill would ensure coverage decisions are made by humans who understand your medical situation—not algorithms designed to cut costs.
H.R. 5269: Fair Payment for Lab Tests
What it does: The “RESULTS Act” reforms how Medicare sets payment rates for clinical laboratory tests.
Why it matters: If you’re on dialysis or managing CKD, lab work is constant—creatinine, BUN, electrolytes, hemoglobin. When payment rates are too low, labs may cut services or exit markets. This bill creates a more sustainable payment system, which could mean easier access to testing.
H.R. 6210: Help Finding Medicare Savings Programs
What it does: The “Senior Savings Protection Act” extends funding for programs that help low-income Medicare beneficiaries find and enroll in cost-saving programs.
Why it matters: More than 90% of Americans with kidney failure have Medicare. But Part B only covers 80% of dialysis—leaving patients responsible for the rest. Medicare Savings Programs can cover premiums, deductibles, and coinsurance, but millions never enroll because they don’t know these programs exist.
Other Bills Worth Watching
- H.R. 2172 (Preserving Patient Access to Home Infusion Act) clarifies Medicare payment for home infusion therapy—relevant for some kidney patients receiving treatments outside dialysis centers.
- H.R. 2902 (SOAR Act) improves access to supplemental oxygen. If you have heart or lung conditions alongside kidney disease, this could help.
- H.R. 5243 increases transparency around Medicare Advantage supplemental benefits—useful if you’re comparing plans.
What You Can Do
None of these bills is specific to dialysis, transplantation, or kidney disease. But the issues they address—AI denials, lab access, navigating Medicare—affect our community every day.
- Contact your representative to share how coverage gaps have affected your care
- Become an NKF Voices for Kidney Health advocate
- Contact NKF Cares toll-free at 1-855-653-2273 for insurance help
We deserve a Medicare system that works for us. These bills aren’t everything we need—but they’re a start.
