In its wish list to Congress on components of a new CKD bill, Kidney Care Partners says permanent reauthorizing of Special Needs Plans is vital to getting services to renal patients.

The Medicare Access and CHIP Reauthorization Act (MACRA) provides an extension to authorization for SNPs through December 31, 2018. However, prior to the enactment of MACRA, the SNP program faced an annual reauthorization process, which created uncertainty for those looking to invest in dialysis-related SNPs. “Special Needs Plans are able to tailor their benefits package to meet specific populations. Due to the highly specialized nature of the plan and the populations they serve, SNPs have demonstrated their ability to efficiently coordinate care and improve patient outcomes,” KCP wrote in its letter to the Senate Finance Committee.

“We recommend that the Working Group permanently reauthorize ESRD SNPs…[to] ensure stability and protect patient access to these plans and allow continued innovation in the treatment of ESRD,” the advocacy group wrote.

The Senate Finance Committee is reviewing S. 598, the Chronic Kidney Disease Improvement in Research and Treatment Act, which focuses on research and improving treatment for individuals with kidney disease.

The KCP also asked the Committee to approve a Voluntary Care Coordination Program for ESRD patients, saying the design of the currently planned Comprehensive ESRD Care Initiative, developed by the Centers for Medicare and Medicaid Services, is “problematic and many questions remain unanswered. KCP is concerned that the “flaws in the initiative’s design will hamper its ability to meet its goal of promoting high-quality care coordination for ESRD beneficiaries.”

The Senate bill includes a provision that would establish an alternative model to the current CMS initiative. “If implemented, this program would, among other things, establish a gain-sharing program for nephrologists, renal dialysis facilities, and providers of services that develop coordinated care organizations to provide a full range of clinical and supportive services for beneficiaries with kidney failure.,” KCP wrote. “The program would be designed to allow all types and sizes of dialysis facility providers to participate and reward them for reducing non-dialysis Medicare costs. Most importantly, the program would prioritize the attribution of beneficiaries on dialysis-to-dialysis facilities participating in the voluntary care coordination program, rather than force them into non-dialysis-based programs. This policy would ensure that beneficiaries relying upon dialysis receive care coordination services from providers whose expertise is in caring for individuals with kidney failure.”