Congress passed a bipartisan budget deal on February 9 that raised the budget caps set forth in a 2011 congressional budget agreement which mandated across-the-board budget cuts known as a sequester. The budget caps deal increased defense and domestic spending by about $300 billion over two years, and raised the debt ceiling until March 2019. Reaching an agreement on increasing the budget caps established topline spending levels that allowed Congress to proceed with appropriations bills that will fund the government for the rest of this fiscal year and fiscal year 2019.

The legislation also incorporated several health care provisions, including the Senate CHRONIC Care Act (S. 870) and the House of Representatives Medicare Part B Improvement Act (H.R. 3178). These bills included the following provisions affecting dialysis patients, which are now passed into law:

  • Permanently reauthorizes Special Needs Plans (SNPs), which are Medicare Advantage plans that exclusively enroll beneficiaries with special needs. There are SNPs for dual-eligible beneficiaries (D-SNPs), institutionalized beneficiaries (I-SNPs) and beneficiaries with certain chronic conditions (C-SNPs), including C-SNPs for ESRD patients.
  • Expands the use of telehealth for Medicare beneficiaries with ESRD who receive home dialysis. Specifically, it allows free standing dialysis facilities and a patient’s home to be originating sites for monthly telehealth clinical assessments, and eliminates geographic restrictions that currently prohibit patients in non-rural areas from using telehealth for clinical assessments. 
  • Allows dialysis facilities to use independent accreditation agencies approved by the Department of Health and Human Services (HHS) Secretary, and directs HHS to conduct surveys and reviews on accrediting agencies and dialysis providers. Currently, in some areas of the country there is a backlog of facilities awaiting accreditation, but unlike hospitals, dialysis facilities have not been allowed to use third-party accreditors.