BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SJR 9|
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THIRD READING
Bill No: SJR 9
Author: Stone (R)
Amended: 6/29/15
Vote: 21
SENATE HEALTH COMMITTEE: 8-0, 6/24/15
AYES: Hernandez, Nguyen, Mitchell, Monning, Nielsen, Pan, Roth,
Wolk
NO VOTE RECORDED: Hall
SUBJECT: The Chronic Kidney Disease Improvement in Research
and Treatment Act
SOURCE: DaVita
DIGEST: This resolution urges the President and the Congress of
the United States to enact the Chronic Kidney Disease
Improvement in Research and Treatment Act (HR 1130). This
resolution makes other findings and declarations about the
prevalence, risks, and research efforts of chronic kidney
disease.
ANALYSIS:
This resolution declares the following:
1)Approximately 50 years ago, kidney failure was a death
sentence.
2)In 1972, Congress developed the Medicare End-Stage Renal
Disease benefit. In doing so, Congress ensured that regardless
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Page 2
of age or income, any American would have access to
life-saving dialysis care. That was the turning point in
kidney care.
3)The Chronic Kidney Disease Improvement in Research and
Treatment Act (HR 1130) was introduced in the House of
Representatives by Representative Tom Marino to address kidney
disease care.
4)House Resolution 1130 is built on three primary tenets. First,
for individuals living with chronic diseases, especially when
those diseases are complicated by multiple comorbid
conditions, coordinated care is key to improving outcomes and
lowering health care costs. Second, increased research can
lead to a deeper understanding of kidney disease prevention
and ultimately to significant innovations in treatment.
Lastly, stability in the Medicare program is central to an
end-stage renal disease program that ensures quality and
produces optimal results.
5)If left untreated, chronic kidney disease (CKD) can progress
to kidney failure, also known as end-stage renal disease, and
early cardiovascular death.
6)More than 20 million adults in the United States, or more than
10% of the adult population, are estimated to have CKD and
most are undiagnosed.
7)Kidney disease is the ninth leading cause of death in the
United States.
8)In the United States, diabetes and high blood pressure are the
leading causes of kidney failure, accounting for 72% or about
three out of four new cases of kidney failure.
9)The number of kidney failure cases in the United States
population has more than tripled since 1990 and is expected to
grow because of an aging population and the increasing number
of people with conditions, such as diabetes and high blood
pressure, that place them at the risk of developing CKD.
Comments
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1)Author's statement. According to the author, kidney diseases
are the ninth leading cause of death in the U.S. More than 20
million adults in the U.S., or more than 10% of the adult
population, are estimated to have CKD. Most cases are
undiagnosed. SJR 9 urges Congress, which created the Medicare
End-Stage Renal Disease benefit back in 1972, to further the
goal of treating and curing CKDs by passing HR 1130.
2)Chronic Kidney Disease. According to the National Kidney
Foundation, CKD is a condition characterized by a gradual loss
of kidney function over time in which bodily wastes are not
properly excreted from the body. Increased levels of waste
can develop into other debilitating symptoms, such as
hypertension, anemia, nerve damage, and poor nutritional
health. According to DaVita, CKD progresses over a period of
years across five stages, stages defined by the level of
functionality of the kidneys. According to the National
Institute of Health's National Library of Medicine, diabetes
and high blood pressure are the leading causes of kidney
failure.
3)HR 1130. HR 1130, introduced in February of this year, is
currently pending in the House Committee on Energy and
Commerce, specifically the Subcommittee on Health. HR 1130
includes three provisions that aim to lessen the severity of
the ninth leading cause of death in the U.S. - CKD.
The first provision is an effort to improve the understanding
of CKD through expanded research and coordination.
Specifically:
a) Requires the Comptroller General to submit a report to
Congress assessing the adequacy of federal funding in CKD
research. The report shall include:
i) Analysis of the current kidney research projects
currently funded by federal monies;
ii) Identification of knowledge gaps in areas of CKD
research;
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iii) The amount of federal funding on CKD research as
compared to the amount of federal funding to treat
individuals with CKD; and,
iv) Identification of knowledge gaps in research to
assess treatment patterns associated with providing care
to minority populations that are disproportionately
affected by kidney failure.
b) Requires the Department of Health and Human Services
Agency (HHS) to establish an interagency committee
responsible for improving the coordination of CKD research.
The committee will issue reports that include
recommendations for communication and coordination among
federal agencies, procedures for monitoring Federal CKD
research activities, and ways to maximize the efficiency of
the federal CKD research investment and minimize the
potential for unnecessary duplication.
c) Requires the Secretary of HHS to issue a complete study
on:
i) The social, behavioral, and biological factors
leading to kidney disease;
ii) Efforts to slow the progression of kidney disease
in minority populations that are disproportionately
affected by such disease; and
iii) Treatment patterns associated with providing care,
under the Medicare program, the Medicaid program, and
through private health insurance, to minority
populations that are disproportionately affected by
kidney failure.
The second provision is an effort to promote access to CKD
treatments. In order to do so, HR 1130 will allow dialysis
facilities to provide kidney disease education services and
will allow physician assistants, nurse practitioners, or
clinical nurse specialists to refer individuals to those
services. Similarly, HR 1130 aims to improve access to CKD
treatment in underserved and rural areas by including dialysis
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as a service provided by the National Health Service Corps in
health professional shortage areas.
The third provision is an effort to create economic stability
for providers caring for individuals with CKD. Specifically,
HR 1130 revises Medicare payments for dialysis services
provided to individuals with end stage renal disease and acute
kidney injury by ensuring that payment adjustments will not
take into account comorbidities. Additionally, the time by
which private health insurers shall not consider a group
health plan enrollee's end stage renal disease in determining
benefits is extended to a 42 month period prior to the date in
which services are furnished beginning on or after January 1,
2016. Lastly, requires HHS, no later than January 1, 2017, to
establish an ESRD Care Coordination gainsharing 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 to
individuals determined to have end stage renal disease.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:NoLocal: No
SUPPORT: (Verified6/29/15)
DaVita (source)
California Dialysis Council
OPPOSITION: (Verified6/29/15)
None received
ARGUMENTS IN SUPPORT: DaVita, the sponsor of the resolution,
states that recognition of CKD as a major health care challenge
is at an all-time high among medical experts, health policy
makers, numerous health-centered non-profit organizations and
the American public. The California Dialysis Council (Council)
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states that while medical advancements have permitted kidney
failure to no longer be a death sentence for patients, those
living with CKD still face very difficult medical procedures and
treatment options. Council states that medical research and
advances are needed concerning CKD.
Prepared by:Reyes Diaz / HEALTH /
7/2/15 15:33:28
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