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Ways and Means Stands Up for Most Vulnerable Patients

July 12, 2016

Tomorrow, the Committee will vote to advance two bipartisan bills that will help improve the quality of health care for some of the nation’s most vulnerable patients.

The Committee will first consider legislation to increase choices and expand access to quality care for patients with End Stage Renal Disease (ESRD)— otherwise known as kidney failure. Under current law, patients suffering from kidney failure are prohibited from enrolling in certain health care programs, such Medicare Advantage (MA). As a result, many of these patients do not have access to quality managed health care plans, cannot afford life-saving treatments, and are not protected from catastrophic health care costs.

The Expanding Seniors Receiving Dialysis Choice Act of 2016, or ESRD Choice Act — introduced by Ways and Means Members Jason Smith (R-MO) and John Lewis (D-GA) — removes the current restriction on ESRD patients so they can access the affordable, effective, integrated health care options that Medicare Advantage provides. The legislation also protects low-income ESRD patients from financially crippling out-of-pocket health care costs by providing access to MA’s catastrophic coverage.

As Dr. Frank Maddox, Chair of Kidney Care Partners — the nation’s largest advocacy organization for quality kidney care — wrote in The Hill:

“The proposed legislation, aptly named ESRD Choice Act of 2016 (H.R. 5659) … will give individuals who develop kidney failure the same freedom of choice offered to every other Medicare beneficiary, allowing them to enroll in MA without restriction. 

“Offering Americans with kidney failure the added choice of Medicare Advantage — an option already available to millions of other Medicare beneficiaries with different health conditions — is the right thing to do. Patients who opt for MA will see many benefits, including the ability to focus on the business of living, staying healthy, and tackling the more enjoyable challenges life will bring.”

The Committee will also consider legislation to deliver targeted support to the approximately 400 Long-Term Care Hospitals (LTCHs) across the country. These hospitals treat patients suffering from the most severe illnesses and injuries. Unfortunately, a handful of one-size-fits-all Medicare policies have not taken into account the needs of the patients LTCHs serve.

The Sustaining Health Care Integrity and Fair Treatment Act of 2016, or the SHIFT Act — introduced by Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH) — helps LTCHs treat the sickest patients by providing targeted relief from some of Washington’s more onerous regulations. It also includes protections to weed out waste and fraud in the Medicare program and ensure limited resources are being spent on the people truly in need of care.

CLICK HERE to learn more about tomorrow’s markup.
CLICK HERE to learn more about the ESRD Choice Act.
CLICK HERE to learn more about the SHIFT Act.