Legislation has been introduced in the House of Representatives that would create voluntary care management demonstration programs for chronic kidney disease (CKD) under the Medicare program. Introduced by Rep. Markwayne Mullin (R-OK), the bill (H.R. 3867) would establish two pilot programs that aim to improve the early detection and treatment of patients with chronic kidney disease through coordinated care, improved patient engagement, and a monthly care management payment to providers linked to performance measures. Other original co-sponsors of the bill are Reps. George Holding (R-NC), Linda Sanchez (D-CA), and G.K. Butterfield (D-NC).
One of the pilot programs, the CKD early detection and treatment (CKD-EDT) demonstration program, would be for Medicare beneficiaries with confirmed CKD equal to stage 3 or greater. CKD-EDT practitioners would develop an integrated care strategy to provide CKD care management services such as blood pressure and lipid management, assessments for bone and mineral abnormalities, patient education on CKD self-management strategies, assessment of mental health and nutritional needs, and medication reconciliation and dosage requirements.
The other pilot program, the advanced CKD demonstration program, would be for Medicare beneficiaries with confirmed CKD at stage 4 or greater. Practitioners in the program can participate in care teams that furnish CKD care management services such as comorbidities assessment and management, patient care planning, mental health assessment and referral, vascular or peritoneal dialysis access assessments, referrals and coordination with transplant centers, and medical nutrition therapy.
Both pilots would waive cost-sharing for services furnished under the demonstration programs and permit the use of telehealth in providing services. Each program would be limited to 5,000 individuals spread evenly across different geographic regions, and be conducted for three years with the option for the Secretary of Health and Human Services to extend the duration and scope of the demonstrations.
The bill was introduced on September 28 and has been referred to the House Energy and Commerce and House Ways and Means Committees. Please contact Mike Ly at firstname.lastname@example.org if you have any questions.