[Congressional Record Volume 147, Number 85 (Tuesday, June 19, 2001)]
[Extensions of Remarks]
[Page E1147]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




INTRODUCTION OF THE MEDICARE DIALYSIS BENEFIT IMPROVEMENT ACT JUNE 19, 
                                  2001

                                 ______
                                 

                             HON. DAVE CAMP

                              of michigan

                    in the house of representatives

                         Tuesday, June 19, 2001

  Mr. CAMP. Mr. Speaker, today I am pleased to introduce the Medicare 
Dialysis Benefit Improvement Act of 2001. This legislation takes 
important steps to help sustain and improve the quality of care for the 
more than 250,000 Americans living with end-stage renal disease (ESRD). 
More specifically, this legislation provides the Medicare reimbursement 
for a routine fourth dialysis treatment for End-Stage Renal Disease 
(ESRD) beneficiaries who require more than three dialysis treatments 
per week.
  Currently, Medicare's composite rate for hemodialysis for the 
individuals with ESRD is a one size fits all reimbursement system. This 
is despite the fact that more than 250,000 individuals with ESRD come 
in all ages, shapes, sides and health statuses. Historically, the 
standard frequency for hemodialysis treatments to remove excess fluid 
and accumulated toxins has been three times a week. Simply increasing 
the usual thrice weekly four hour treatment sessions will not solve a 
problem as there are diminishing returns for longer sessions and this 
would decrease the rehabilitation potential of these patients and 
increase noncompliance.
  It is estimated that only 10-15 percent of patients would actually 
receive a fourth treatment a week. While Medicare rules allow payment 
for additional hemodialysis treatments beyond the standard three times 
a week on a case by case basis for fluid overload, pericarditis and a 
few other unusual conditions, Medicare's fiscal intermediaries rarely 
approve claims for more than three treatments per week.
  Furthermore, this legislation takes into consideration the Medicare 
Payment Advisory Commission (MedPAC) report recommendation of a 2.6 
percent increase to sustain patients'access to dialysis services in the 
2002. This proposal would help ensure all dialysis providers receive 
the reimbursement that is in line with increasing patient load and 
quality requirements. The dialysis reimbursement is the only Medicare 
provider reimbursement that does not include an annual inflation 
adjustment. Therefore the only way in which dialysis reimbursement can 
be updated is by Congressional action.
  As Congress considers further improvements to the Medicare program, I 
urge my colleagues to support this important effort to ensure patients 
with kidney failure continue to have access to quality dialysis 
services. I thank my colleagues for working together on this bipartisan 
proposal.

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