S2730119th CongressWALLET

Kidney Care Access Protection Act

Sponsored By: Senator Marsha Blackburn

Introduced

Summary

Creates a permanent add-on for new kidney therapies. The bill would extend transitional payment periods for new dialysis drugs and devices, require Medicare Advantage direct payments to match transitional payments, and add a forecast-error mechanism to stabilize ESRD payment updates beginning January 1, 2026.

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  • Patients and families: Would boost access to new dialysis drugs and devices by extending transitional coverage for at least 3 years and by keeping a post-transitional add-on in place after that period.
  • Providers and dialysis facilities: Would receive a permanent post-TDAPA add-on calculated from utilization and price data, equal to 65% of the calculated amount and updated for inflation, and that add-on would not be subject to patient-level case-mix adjustments.
  • Medicare Advantage plans and developers: MA plans would be required to make direct payments to providers for TDAPA-recognized items for the duration of the transitional payment. Devices in FDA’s Breakthrough Devices program would become eligible for transitional payments starting January 1, 2026 and capital-related assets may qualify for TDAPA treatment.

*Would increase Medicare spending because the permanent add-on is specified as not budget neutral.*

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

More payments for dialysis devices

If enacted, this bill would expand transitional Medicare payments for new dialysis devices. It would make FDA Breakthrough-designated dialysis devices eligible for transitional add-on payments starting January 1, 2026. It would require payment for qualifying devices for not less than three years and would let capital-related device assets be included when they otherwise qualify.

More stable Medicare dialysis payments

If enacted, this bill would extend and add new Medicare payments tied to dialysis drugs and related items. It would require at least three years of transitional drug payments for qualifying new dialysis drugs starting January 1, 2026. It would create a permanent post-transitional add-on for qualifying drugs equal to 65% of spending per dialysis service, using recent utilization and price data, updated for inflation. The bill would also require Medicare Advantage plans to make direct payments like the ESRD system for these transitional items beginning January 1, 2026. If enacted, the Secretary would add a yearly "forecast error" adjustment to ESRD payment updates starting in 2026 when price forecasts differ by more than 0.5 percentage points. The bill would exclude certain drugs approved after Dec 31, 2025 that treat comorbid conditions from the ESRD base rate and would require a special AY claim modifier on those provider claims.

Sponsors & CoSponsors

Sponsor

Marsha Blackburn

TN • R

Cosponsors

  • Cory Booker

    NJ • D

    Sponsored 9/8/2025

  • Bill Cassidy

    LA • R

    Sponsored 3/24/2026

Roll Call Votes

No roll call votes available for this bill.

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