Help Protect Kidney Transplant Patients’ Access to Immunosuppressive Drugs Under Medicare Part D
As you know,individuals who are fortunate enough to receive a kidney transplant must take immunosuppressive medications for the life of the transplanted kidney to reduce the risk of losing the organ. Some patients rely on Medicare Part D to cover the cost of these medications.
Immunosuppressive drugs are one of six “protected classes” of drugs under Medicare Part D.This means that Medicare Part D must cover all approved immunosuppressive drugs, giving transplant recipients access to the full range of available medications. On January 10, 2014, the Centers for Medicare & Medicaid Services (CMS) proposed a change to Medicare Part D that would revise the criteria for these protected classes of drugs. Part D plans would no longer be required to cover all approved immunosuppressive medications.
This rule would put transplant patients’ health at significant risk. Transplant recipients often need adjustments to their immunosuppressive drug regimen, and therefore they require access to the full range of approved medications.
At The Hope Affair, the American Kidney Fund's national gala, NeShell Monroe was honored as the 2013 Hero of Hope. NeShell works tirelessly to encourage and empower other patients at her dialysis facility to care for themselves and to live their lives to the fullest. She reaches out to the community at local health events and through the media to educate people about kidney disease and its leading causes, the importance of early detection, and how to prevent kidney disease. NeShell has traveled to Washington, D.C., to meet with legislators and help them understand how their policy decisions affect kidney patients.
CMS Releases Final Rule on ESRD Payments
On November 22, 2013, the Centers for Medicare & Medicaid Services (CMS) released its final rule that will result in a 12 percent cut in Medicare dialysis payments for people who have end-stage renal disease (ESRD).
The American Kidney Fund advocated against these cuts as we believe they will have negative consequences on ESRD patients’ access to quality care and services. In addition, over 1,000 letters were sent to members of Congress from our Advocates expressing concern with the proposed cuts.
According to the final rule, payments will remain the same for 2014 and 2015; however, the full $30 cut per treatment will be phased in over the next 3-4 years. AKF remains concerned that this cut may limit ESRD patients’ treatment options and, although the phase-in is a less drastic approach, it will not mitigate the potential for challenges regarding access to quality care in the future. Since 2011, the Medicare ESRD program has undergone a series of significant payment reforms and reductions so we will be closely monitoring how these sequential cuts will impact patient care. Read AKF’s statement regarding the rule.