The ASN Policy Board presents the October issue of Renal Policy Express.
In This Issue...
- ASN Public Policy Update
Updates including the September meeting with NIDDK leadership, ASN Public Policy Board Forum, and the Christopher Blagg Lectureship.
- Regulatory Issues
CMS Releases Average Sales Price Amounts for October 1st through December 31st.
- National Institutes of Health
New USRDS Report Available Online and NIDDK Releases Publication Targeting African Americans at Risk for CKD.
- Congressional Actions
Learn about the latest legislation and hearings.
- Other
Washington Post Article Questions Organ Procurement, Community Responds.
1. Policy Board Update
Public Health Consequences Meeting
On September 24, 2007, leadership from the ASN Council and Policy Board met with Dr. Griff Rodgers, Director of the National Institute of Digestive and Diabetes and Kidney Diseases (NIDDK), Dr. Rob Star, Acting Director of the Division of Kidney, Urologic, and Hematologic Diseases (KUH), and Dr. Andrew Narva, Director of the National Kidney Disease Education Program (NKDEP). ASN was represented by Drs. Coffman, Himmelfarb, and Hostetter, who focused the meeting on the public health consequences of kidney disease and a sustained kidney disease research agenda.
Public Policy Forum Reminder
The ASN Public Policy Board Forum will be held from 1:30-3:30 on Saturday, November 3, 2007 in Room 304 of the Moscone Center in San Francisco, CA. The subject will be "The Past, Present, and Future of Clinical Nephrology Practice" and will be moderated by Jonathan Himmelfarb, MD, and Connie Davis, MD. Speakers include Barry Straube, MD, Director & Chief Clinical Officer, Office of Clinical Standards and Quality at CMS, Peter DeOreo, MD from Case Western School of Medicine and Allen Nissenson, MD, from the David Geffen School of Medicine at the University of California at Los Angeles. You can read a description of the session here.
Christopher Blagg Lectureship
The 2007 Christopher Blagg Lecture, "Stacking the Deck: An Examination of the Guideline Development Process," will be given by Jerome Kassirer, MD, Tufts University of Medicine. It will be part of the Public Policy Session "Nephrology Practice in the ‘Grey Zone’: Exploring Industrial Influence in Clinical Practice Guideline Development" scheduled for 1:30pm on Friday, November 2, 2007 in Room 304. This session will be sponsored by the Renal Physicians Association and other speakers will include Alan Kliger, MD and David Van Wyck, MD.
2. Regulatory Issues
CMS Releases Average Sales Price Amounts for October 1st through December 31st
The Centers for Medicare & Medicaid Services (CMS) has made available the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for October 1, 2007 to December 31, 2007. You can view them at: http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a_2007aspfiles.asp.
3. National Institutes of Health
New USRDS Report Available Online
The 2007 U.S. Renal Data System Report (USRDS) is now available at www.usrds.org/adr.htm. The latest data reports that chronic kidney disease (CKD) and end stage renal disease (ESRD) patients accounted for 6.6 percent and 1.2 percent of the general Medicare population, but accounted for 19.4 percent and 8.2 percent of total costs, respectively. The report also states that the total number of people receiving treatment has increased to 485,000, with 341,319 on dialysis and 143,693 patients surviving with a functioning transplant.
NIDDK Releases Publication Targeting African Americans at Risk for CKD
The National Kidney Disease Education Program has created a new brochure that explains the connection between diabetes, high blood pressure, and kidney disease and encourages the at-risk population to talk with their health care providers about getting tested. African Americans are disproportionately affected by kidney failure, as well as its most common risk factors: diabetes and hypertension. The brochure encourages testing, even without symptoms. To read about the brochure, visit: www.nkdep.nih.gov.
4. Congressional Actions
Support Builds for Legislation to Extend Immunosuppressive Drug Coverage
On August 1, 2007, Rep. Dave Camp (R-MI), introduced a bill in the House of Representatives "To amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare Program that have received a kidney transplant and whose entitlement to coverage would otherwise expire, and for other purposes." There are currently 26 cosponsors, which you can view here: http://thomas.loc.gov/cgi-bin/bdquery/z?d110:HR03282:@@@P
The Immunosuppressive Drug Coalition, of which ASN is a member, has been lobbying Congress in support of this bill. You can a view a history of immunosuppressive drug coverage here, and a fact sheet about the drugs here.
After its introduction, the bill was referred to the Committees on Ways and Means, Energy and Commerce, and Education and Labor.
State Children’s Health Insurance Program (SCHIP) Legislation
The Senate voted 69-30 in favor of passage of the SCHIP Legislation on Thursday, September 27, 2007. This $35 billion measure would revamp and expand the State Children’s Health Insurance Program, set to expire on September 30, 2007. The Senate vote has a wider margin than necessary to overcome a promised veto from President Bush. For a summary from the Washington Post, click here: http://www.washingtonpost.com/wp-dyn/content/article/2007/09/27/AR2007092701038.html?hpid=topnews.
The House of Representatives voted 265-159 in favor of the measure on Tuesday, September 25, 2007, falling 25 votes short of the 290 needed to override a veto.
The proposed Medicare revisions (including ESRD provisions) and the physician fee fix have been stripped from the SCHIP legislation. Instead, the Senate Finance Committee is working on a separate bill to reverse the 10% cut in Medicare physician payment rates scheduled to take effect January 1, 2008. The legislation would reverse the cut by decreasing reimbursements to Medicare Advantage plans. President Bush has not yet made a statement on his intentions regarding this legislation.
Senate Passes Appropriations Bill with $500 Million for VA Research
The Senate approved on September 6, 2007, the fiscal year 2008 Military Construction and Veterans Affairs Appropriations bill, which provides $36.6. billion for Veterans’ Affairs (VA) medical care and $500 million for VA medical and prosthetics research. The appropriations bill previously passed in the House as well, and conferees have been appointed to resolve the differences between the chambers’ bills.
The Senate will consider the Commerce-Justice-Science bill (HR 3093) beginning October 1, 2007 and will then move to the Defense spending bill (HR 3222). The Labor-HHS-Education bill (HR 3043) will then be considered after the Columbus Day break.
Oversight & Government Reform Subcommittee Holds Hearing on Organ Donation
The Information Policy, Census, and National Archives Subcommittee of the Oversight & Government Reform Committee, held a hearing on September 25, 2007, to discuss “using public policy and technology to strengthen organ donor programs. ASN staff was in attendance as Everson Walls, a kidney donor and retired National Football League (NFL) player from the Dallas Cowboys, gave testimony to the importance of living donors and early screening for CKD.
Other witnesses included:
- James Burdick, Health and Human Services Department,
- Clive Callender, founder of the Minority Organ Tissue Transplant Education Program (MOTTEP),
- Jeffrey Crippen – Washington University School of Medicine,
- Susan Dunn – president-elect of the Association of Organ Procurement Organizations (AOPO),
- Timothy Pruitt – president of the United Network for Organ Sharing (UNOS),
- Elizabeth Rubin – liver recipient and past president of the, and Transplant Recipients International Organization.
As Congress reconvenes following the August recess, a conference committee will attempt to draft a compromise between the two substantially different bills. President Bush has threatened to veto both of them, arguing that they provide for too large an expansion of government-run health care. The Senate bill passed with a veto-proof version; the House bill did not.
5. Other
Washington Post Article Questions Organ Procurement, Community Responds
A recent article published in the Washington Post questioned organ donation practices and related a case where doctors allegedly tried to hasten the death of a sick patient in order to harvest his organs. Prosecutors brought charges against the transplant surgeon, and the article did not imply that this case was a usual occurrence, but it did discuss the ethics involved in organ donation. You can read this article here: http://www.washingtonpost.com/wp-dyn/content/article/2007/09/12/AR2007091202681.html.
Melissa Honohan, Assistant Executive Director of the Association of Organ Procurement Organizations (AOPO), responded with a letter to the editor from the transplant community. You can read her letter here: http://www.washingtonpost.com/wp-dyn/content/article/2007/09/21/AR2007092101918.html?sub=AR.
We hope that you have enjoyed this version of ASN's Renal Policy Express. Please refer any questions or comments regarding this newsletter to policy@asn-online.org.
Paul Smedberg, Director, Policy and Public Affairs
Susan Owens, Policy and Public Affairs Coordinator
