Kidney Care Access Protection Act
Sponsored By: Representative Miller (WV)
Introduced
Summary
Accelerate Medicare access to innovative kidney treatments and expand early screening and education. This bill would create new, inflation-adjusted payment add-ons for dialysis drugs and devices while expanding Medicare wellness screenings and kidney disease education to improve detection and care.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 3 benefits, 0 costs, 2 mixed.
Longer transitional payments for dialysis
This bill would require at least three years of transitional add-on payments for new dialysis drugs and for qualifying new dialysis devices furnished on or after January 1, 2026. Devices with certain FDA expedited designations would be eligible. Capital-related assets that meet program rules would also be eligible for the device add-on. The bill would also require Medicare Advantage plans to make direct payments to providers equal to the ESRD payment amount for items that get those transitional add-ons starting January 1, 2026.
More kidney care education and screening
This bill would expand Medicare kidney disease education to people with stage V disease as well as stage IV. It would let physician assistants, nurse practitioners, clinical nurse specialists, and qualifying dialysis facilities provide that education. Payment for the education would not be in the single composite dialysis payment. Instead, facilities would be paid separately on an assignment-related basis. The bill would also add chronic kidney disease screening to the Medicare annual wellness visit starting January 1, 2026.
Permanent drug add-on for dialysis
This bill would create a permanent post-TDAPA add-on to the ESRD base rate for qualifying new dialysis drugs. The add-on would equal 65% of total Medicare spending on the drug divided by the number of dialysis services when it was given. Calculation would use the most recent 12 months of use and the latest full quarter of average sales price data, with fallbacks to wholesale cost or the manufacturer's invoice when needed. The add-on would be updated for inflation annually and apply to claims submitted on or after January 1, 2026.
New forecast adjustment for dialysis payments
This bill would require a yearly forecast error adjustment to the factor that updates Medicare ESRD payment amounts starting in 2026. The first adjustment would cover cumulative forecast error for 2021 and 2022. Later adjustments would use the most recent year with final data. The adjustment would apply whenever the forecast error for relevant dialysis goods and services exceeds 0.5 percentage points.
Separate billing for new comorbid drugs
This bill would change which drugs count as part of the dialysis base rate. Drugs or biologics approved after December 31, 2025 that treat other conditions (for example, heart disease, cancer, diabetes, obesity) and do not replace a base-rate dialysis drug would be excluded from the ESRD base rate and could be billed separately under Part B for dialysis patients. Claims for those excluded drugs furnished by providers or dialysis facilities would have to include the AY modifier (or a successor) starting on enactment. The exclusion would apply to items and services furnished on or after January 1, 2026.
Sponsors & CoSponsors
Sponsor
Miller (WV)
WV • R
Cosponsors
Sewell
AL • D
Sponsored 11/20/2025
Clarke (NY)
NY • D
Sponsored 12/10/2025
Rulli
OH • R
Sponsored 1/12/2026
Tenney
NY • R
Sponsored 1/14/2026
Kelly (PA)
PA • R
Sponsored 1/30/2026
Carter (LA)
LA • D
Sponsored 2/17/2026
Murphy
NC • R
Sponsored 2/23/2026
Davis (NC)
NC • D
Sponsored 3/16/2026
Roll Call Votes
No roll call votes available for this bill.
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