Kidney Care Access Protection Act

Key Points

• The bill extends the transitional drug add-on payment adjustment (TDAPA) period to at least 3 years for new dialysis drugs and biologicals approved by the FDA on or after January 1, 2020. This gives dialysis providers more time to adopt new treatments without financial risk.
• After the transitional payment period ends, the bill creates a permanent add-on adjustment to the Medicare base rate so that innovative dialysis drugs don't lose their separate funding. The permanent payment is set at 65% of the calculated per-treatment cost of the new drug.
• New drugs for common comorbid conditions like heart disease, diabetes, cancer, and obesity in dialysis patients are excluded from the bundled dialysis payment, meaning they'll be paid for separately. This prevents clinics from absorbing the cost of these treatments.
• The bill ensures Medicare Advantage enrollees with kidney failure get the same access to new dialysis treatments by requiring direct payments to providers for innovative drugs and devices, matching what traditional Medicare pays.
• To help dialysis centers cover rising labor and supply costs, the bill adds a forecast error adjustment to the annual payment update. If past cost predictions were off by more than 0.5 percentage points, Medicare must correct the shortfall — starting with corrections for 2021 and 2022.