The Centers for Medicare and Medicaid Services (CMS) in 2025 is set to move oral-only drugs into the Medicare Part B End-Stage Renal Disease (ESRD) prospective payment system, action that U.S. Reps. Buddy Carter (R-GA) and Carol Miller (R-WV) say will threaten kidney disease patients’ access to life-saving medications and increase costs for dialysis treatments.
“Let’s pass this bill and stop CMS from gambling with patients’ lives,” said Rep. Carter.
To delay the CMS move until 2033 or until new intravenous therapies come to the market, the lawmakers on July 28 introduced the bipartisan Kidney Patient Access to Technologically Innovative and Essential Nephrology Treatments (PATIENT) Act of 2023, H.R. 5074. Rep. Carter sponsored H.R. 5074 with three original cosponsors, including Rep. Miller and U.S. Rep. Annie Kuster (D-NH).
Specifically, H.R. 5074 would amend the American Taxpayer Relief Act of 2012 to delay implementation of the inclusion of oral-only ESRD-related drugs in the Medicare ESRD prospective payment system, according to the text of the bill.
“We cannot let bureaucracy get in the way of patients’ health and well-being,” Rep. Carter said. “As a pharmacist, I know just how important it is for patients, especially those with kidney disease, to be able to access and afford the medicine prescribed by their doctor. This is bipartisan, it’s been done before, and it will save taxpayer dollars.”
Rep. Miller added that kidney patients should be able to access as many therapies as possible, as cost-effectively as possible.
“Access to oral-only drugs is critical to many patients,” said Rep. Miller. “The Kidney PATIENT Act will not only save taxpayers money but provide affordable treatment for kidney patients across the country.”
The bill has garnered support from several stakeholder groups, including the Renal Support Network, the MTS Sickle Cell Foundation, the National Association of Nutrition and Aging Services Programs, the National Grange, the National Minority Quality Forum Action Network, and the National Consumers League.
“Patients with complex medical conditions like ESRD must have access to the medications that they need,” said Rep. Kuster. “Changes in Medicare’s ESRD Prospective Payment System could create barriers to essential medications and should be delayed until it’s clear that patients’ access will not be impacted.”