Although we are all disappointed our legislation did not
make it into
consideration for these final days of Congress, I thought
you would be
interested in knowing the House bill has gained about a
half dozen
cosponsors in the past week. That is encouraging,
considering most if not
all of us have not done face-to-face meetings with Hill
staff this month.
This is the result of your organizations' efforts with
e-advocacy,
petitions, letters, etc., which I know many of you have
been doing. NKF
plans to issue an Action Alert to our patient and
professional advocates in
early January.
Thanks to all of you for your hard work throughout the
year. As a
congressional staff member involved in this recently wrote
me, "keep up the
good fight, we'll get there eventually."
I wish you each of you a wonderful Holiday.
Troy Zimmerman
Vice President for Government Relations
National Kidney Foundation Legislative Initiative and TRIO Public Policy UPDATE
Nov 2011....
For detail wording on each bill, click on the titles:
There
is a new bill introduced in the United States Senate.
What follows is some information with respect to S.
1454: Comprehensive Immunosuppressive Drug Coverage for
Kidney Transplant Patients Act of 2011-112th Congress:
2011-2012.
S.
1454: A bill to amend title XVIII of the Social Security
Act to provide for extended months of Medicare coverage
of immunosuppressive drugs for kidney transplant
patients and other renal dialysis provisions.
The
Comprehensive Immunosuppressive Drug Coverage for Kidney
Transplant Patients Act of 2011
TRIO
has worked hard to forward the goal of extending
Medicare coverage of immunosuppressive drugs for kidney
transplant recipients beyond the current 36 months post
transplant. It was hoped that this would be part of any
health care reform legislation that was passed. It was
not, however, part of the health care reform legislation
that was passed. Although this legislation was included
in the health bill approved by the House of
Representatives in November of 2009, the bill and this
important legislation was not contained in the Senate
bill in December nor in the final legislation signed by
the President in March of 2010. However, the original
immunosuppressive bills (S. 565, H.R. 1458) remain
active and I would ask you to please help by asking your
Representatives and Senators to become cosponsors if
they are not yet cosponsors. Please contact your
Senators and Representative to urge them to cosponsor
the Senate bill- S. 565 and The House Of Representatives
bill- H.R. 1458, respectively.
Senate
Amdt. 3102 to H.R. 3590- 2010 failed to be included in the
bill signed by President Obama even though it was included
in the original House bill.
Background:
Prior
to 2000, immunosuppressive drug coverage was limited
to 36 months following a transplant for all kidney
transplant recipients. In the Beneficiary
Improvement and Protection Act of 2000, Congress
eliminated the 36-month limit for transplant
recipients who had a Medicare transplant, if they
are eligible for Medicare based on age or
disability.
Recipients would pay the
individual portion of the Part B premium, and Medicare
would be extended beyond 36 months only for recipients
who lack other health care coverage. All other health
care needs for transplant recipients who are not
Medicare aged or disabled would remain subject to the
current ESRD 36 month coverage limit.
Organ transplant recipients must take immunosuppressive
medications for the life of the transplant to help
prevent the body from rejecting the organ. HR 1458 would
extend immunosuppressive drug coverage for
Medicare-eligible kidney transplant recipients for the
life of the transplant. They would not necessarily have
access to other parts of Medicare, but this would ensure
that they could retain Part B access to these expensive
medications. Currently, Medicare pays for most kidney
transplants but covers medications for only 36 months
post-transplant as part of the Medicare ESRD benefit.
Many kidney patients lose access to Immunosuppressive
medications. In a study of 1,000 kidney transplant
recipients, graft loss more than doubled when Medicare
coverage for anti-rejection drugs ended.This is
associated with a significant cost to Medicare and the
taxpayers because patients who lose transplanted kidneys
must return to dialysis or seek another transplant.
Furthermore, once a transplanted kidney no longer works,
the patient’s risk for death is nine times as large!
In a survey by the United Network for Organ Sharing and
the American Society of Transplantation, 70% of
transplant centers report that patients have extreme or
very serious problems paying for their medications, and
68% of kidney transplant deaths or graft failures are
possibly the result of lack of access to anti-rejection
medications.
According to the most recent report from the United
States Renal Data System, Medicare spends an average of
$77,000 per year indefinitely dialyzing patients with
kidney failure. However, it spends $106,000 the first
year after transplant and an average of $17,000 per year
thereafter, including the cost of Immunosuppressive
medications. It thus makes financial sense for Medicare
to remove the 36-month coverage limitation for
Immunosuppressive medications.
In the most recent report, we discussed an important
bill introduced in the United States Senate. Today, I'm
pleased to announce that a companion bill has been
introduced in the House of Representatives with
bipartisan support and co-sponsorship. In the House of
Representatives, Michael C. Burgess, M.D. (R–Texas) and
Congressman Ron Kind (D–Wisconsin) introduced the
Immunosuppressive Drug Coverage for Kidney Transplant
Patients Act. This legislation, H.R. 2969 will allow
individuals who are eligible for immunosuppressive drugs
under Medicare Part B to continue to receive their vital
treatment past the 36-month cutoff. Without these
medications, transplant recipients are at risk to lose
their transplanted kidneys which has too often happened.
Since 1972, Medicare has covered people with
irreversible kidney failure, or end-stage renal disease
(ESRD). There is no Medicare time limit for a dialysis
patient. However, kidney transplant recipients lose
their Medicare coverage 36 months after a transplant.
Extending immunosuppressive coverage beyond the 36-month
limit would decrease the risk of organ failure due to
patients neglecting to take the immunosuppressants
following loss of immunosuppressive coverage.
Furthermore, it has been found that transplant
recipients have a higher quality of life, and are more
likely to return to work than dialysis patients.
As was announced in the most recent public policy
report, U.S. Senators Dick Durbin (D–Illinois), Thad
Cochran (R–Mississippi) and Scott Brown
(R–Massachusetts) have introduced companion legislation
in the Senate.
- Mike Sosna
TRIO Public Policy Committee Chairman
Sponsor: Sen. Richard
Durbin [D-IL] Status: This bill is in
the first step in the legislative process. Source: Senator Dick
Durbin's Office July 29, 2011
DURBIN, COCHRAN INTRODUCE LEGISLATION TO HELP ORGAN
TRANSPLANT PATIENTS
WASHINGTON, DC – U.S. Senators Dick Durbin (D-IL), Thad
Cochran (R-MS), and Scott Brown (R-MA) today introduced
bipartisan legislation to improve the quality of life
for people with kidney disease. The 2011 Comprehensive
Immunosuppressive Drug Coverage for Kidney Transplant
Patients Act would assist thousands of Americans under
the age of 65 who are being cut off from Medicare after
36 months by extending coverage of immunosuppressive
drugs for kidney transplant recipients. Also
cosponsoring today’s legislation were U.S. Senators
Daniel Inouye (D-HI), Chuck Schumer (D-NY), Carl Levin
(D-MI) and Ben Cardin (D-MD). Congressman Michael
Burgess, M.D. and Congressman Ron Kind are planning to
introduce companion legislation in the House of
Representatives within the next few weeks.
“Of the 89,000 patients waiting for an kidney
transplant, those patients lucky enough to undergo a
successful transplant should not have to worry about
being able to pay for the medication that will reduce
the risk of organ rejection,” said Durbin. “In 2000,
Congress passed legislation that provided older or
disabled individuals lifetime coverage for
immunosuppressive drugs through Medicare. Today’s
legislation will extend that coverage to all patients
trying to live healthy lives after kidney transplants.”
“Our legislation is intended to help people with
end-stage renal disease and offset long-term costs to
the government for treatment of this condition. Kidney
transplants are often the best option for these
patients, and this bill would help in providing the
immunosuppressive drugs needed to make transplants
successful. In states like Mississippi with high
incidences of diabetes and related kidney failures,
extending this coverage to younger patients could mean
improved health and quality of life,” Cochran said.
According to United Network for Organ Sharing,
approximately 28,000 organ transplants were performed
last year in the United States. The vast majority of
transplants – over 16,800 Americans in 2010 – are
provided to patients in need of a kidney because they
are living with End Stage Renal Disease, ESRD, or kidney
failure. However, for thousands of working Americans who
had not yet reached 65 and were not disabled, treatment
was cut off after 36 months regardless of their ability
to pay for lifesaving therapy that can run more than
$1,000 a month.
“Extending coverage beyond 36 months for those suffering
from end stage renal disease is just common sense. It’s
good policy, it saves money, but most importantly, it
saves lives,” said Brown. “No one should lose a
transplant because they are not able to pay for the
drugs to maintain it.”
“This legislation is a commonsense approach to both
maximizing taxpayer money while increasing the quality
of life for kidney transplant recipients,” said Dr.
Burgess who is the Vice Chair of the House Energy and
Commerce Committee’s Subcommittee on Health and Chairman
of the Congressional Health Care Caucus. “Without this
legislation, transplant recipients face the potential of
losing access to their immunosuppressive medications
after 36 months which places them at a higher risk for
losing their new kidney and being placed back on
dialysis – a situation that has a proven higher cost to
taxpayers and does not improve the quality of life.”
“Health care costs are the fasting growing area of
spending in the national budget,” said Rep. Kind. “We
should be doing everything we can to improve patient
care while getting these costs under control and this
legislation is a great step in the right direction.
Providing kidney transplant patients access to the
medication to ensure the success of their transplant
helps keep health care costs down – by decreasing the
need for further dialysis and the likelihood of a
re-transplant - and the quality of life up – so that
patients won’t have to worry about how they will pay for
the medicine to maintain their health.”
The effects of the disparity in coverage are evidenced
in the hypothetical case of a young woman. A 26 year old
woman living with ESRD would have lifelong dialysis
covered by Medicare at $77,500/year. Medicare would
cover the cost of a transplant at $110,000/transplant.
The immunosuppressive drugs she would need to ensure the
organ is not rejected by her body are only covered for
36 months and the drugs are far less costly at $10,000
to $20,000/year. Without immunosuppressive drugs to keep
kidney transplants from being rejected, many patients
find themselves right back where they started: in need
of a kidney. This circular cycle of care is costing
taxpayers a lot of money and putting thousands of lives
at risk.
_____________________________________________________________________________________________________________________________________________________________________________________ Here is the
companion bill in the House Of Representatives: Status:
Referred to House Ways and Means
Burgess, Kind
Introduce Legislation to Protect Kidney Transplant
Recipients
Washington, D.C. – Last night,
Congressman Michael C. Burgess, M.D. (R–Texas) and
Congressman Ron Kind (D–Wisconsin) introduced the
Immunosuppressive Drug Coverage for Kidney
Transplant Patients Act. This legislation, H.R.
2969 will allow individuals who are eligible for
immunosuppressive drugs under Medicare Part B to
continue to receive their vital treatment past the
36-month cutoff. Without these drugs, transplant
recipients are at risk to lose their transplanted
kidneys – which too often happens.
“Although now more mainstream than heroic, renal
transplantation offers end stage renal disease
patients an alternative to a lifetime of
dialysis,” said Congressman Michael C. Burgess,
M.D. who is the Vice Chair of the House Energy and
Commerce Committee’s Subcommittee on Health and
Chairman of the Congressional Health Care Caucus.
“How incredibly cruel then, that the gravest
threat to their newly acquired kidney is an
incoherent federal policy that denies coverage for
anti-rejection drugs after 36 months and a
costlier return to patients and the Medicare
system to dialysis.”
Since 1972, Medicare has covered people with
irreversible kidney failure, or end-stage renal
disease (ESRD). There is no Medicare time limit
for a dialysis patient. However, kidney transplant
recipients lose their Medicare coverage 36 months
after a transplant. Extending immunosuppressive
coverage beyond the 36-month limit would decrease
the risk of organ failure due to patients
neglecting to take the immunosuppressants
following loss of immunosuppressive coverage.
Furthermore, transplant recipients have a higher
quality of life, and are more likely to return to
work than dialysis patients.
“Health care costs are the fasting growing area of
spending in the national budget,” said Rep. Kind.
“We should be doing everything we can to improve
patient care while getting these costs under
control and this legislation is a great step in
the right direction. Providing kidney transplant
patients access to the medication to ensure the
success of their transplant helps keep health care
costs down – by decreasing the need for further
dialysis and the likelihood of a re-transplant -
and the quality of life up – so that patients
won’t have to worry about how they will pay for
the medicine to maintain their health.”
"On behalf of the American Society of
Transplantation (AST), representing the majority
of professionals engaged in the field of organ
transplantation, I strongly applaud Congressmen
Burgess (R-TX) and Kind (D-WI) for their
leadership in introducing the ‘Comprehensive
Immunosuppressive Drug Coverage for Kidney
Transplant Patients Act of 2011’," said Dr. Bob
Gaston, President of the American Society of
Transplantation (AST). “This bipartisan and
bicameral legislation will ensure that kidney
recipients are able to maintain their life-saving
donor organ. This is a common sense approach that
will save both lives and federal funds by
preventing organ rejection, re-transplantation and
more costly therapies already covered under
Medicare. The transplant community and the patient
population that it serves are extremely grateful
to Congressmen Burgess and Kind for their
steadfast commitment to this issue and the lives
that will be saved as the consequence of their
efforts."
"The National Kidney Foundation commends
Representatives Burgess and Kind for their
leadership on this critically important
legislation. This bill, coupled with the companion
legislation by Senators Durbin and Cochran, will
ensure that thousands of Americans can keep their
transplants, allow thousands more to be
transplanted, and reduce the need for
re-transplants of people who can no longer pay for
vital medication and who end up back on dialysis
and the transplant waiting list. This legislation
is a major first step towards achieving the goal
of the National Kidney Foundations END THE WAIT!
initiative to find solutions to the organ shortage
and eliminate the all-too-long wait for a
transplant," said Lynda Szczech, MD, National
Kidney Foundation President.
U.S. Senators Dick Durbin (D–Illinois), Thad
Cochran (R–Mississippi) and Scott Brown
(R–Massachusetts) have introduced companion
legislation in their respective chambers.
______________________________________________
Take action now:
Reach out to your legislators and express your support of
the important legislation above. The life you save may
be yours or that of others around the country with your
actions.
One way
of supporting this legislation would be to read and act on
the following petition request:
After receiving a
kidney transplant, a patient must take immunosuppressive
drugs for the rest of his/her life, at a cost of $19,000
per year. Without these drugs, the body will reject the
organ and the patient will have to go on dialysis.
Under current law,
Medicare covers these medication costs for
three years only, but will cover much
higher dialysis costs – $77,000 per year
– indefinitely.
The Comprehensive
Immunosuppressive Drug Coverage for Kidney Transplant
Patients Act, currently in the U.S. Senate and
House of Representatives, will extend that Medicare
coverage for the rest of the patient’s life. This will
help patients to keep their kidney transplants,
shorten the transplant waiting list, and lower
Medicare costs. Both Democrats and
Republicans in Congress support this measure.
It is good
for transplant patients, good for taxpayers, and good
for the national budget.