Chronic Kidney Disease Improvement in Research and Treatment Act of 2023

This bill aims to improve understanding of and access to treatment for chronic kidney disease by expanding Medicare coverage, incentivizing innovation, addressing workforce issues, and expanding patient coverage choices. It makes several amendments to the Social Security Act and the Public Health Service Act.

TITLE I, Preventing Kidney Disease and Expanding Awareness and Education: Sec. 101 expands the Medicare annual wellness benefit to include chronic kidney disease screening. Sec. 102 increases access to the Medicare kidney disease education benefit by expanding eligibility to patients with stage V kidney disease and allowing physician assistants, nurse practitioners, and clinical nurse specialists to provide education; it also allows renal dialysis facilities to provide these services and be paid separately.

TITLE II, Incentivizing Kidney Care Innovation: Sec. 201 refines the end-stage renal disease (ESRD) payment system to improve payment accuracy for new and innovative drugs, biologicals, and devices by creating an add-on adjustment after a transitional payment period, and requires the Secretary to ensure the single payment amount covers the cost of new devices with substantial clinical improvement. Sec. 202 ensures Medicare Advantage plans support innovative therapies by requiring the Secretary to directly make payment adjustments for innovative products to providers and dialysis facilities. Sec. 203 requires a study on increasing kidney transplantation rates, analyzing disincentives in Medicare payment systems, state practices, minority donation rates, and cultural/policy barriers, with a report to Congress due within 18 months.

TITLE III, Addressing the Kidney Care Workforce Crisis: Sec. 301 ensures accuracy and stability in kidney care payment by requiring the Secretary to compute a forecast error adjustment to the annual update of the ESRD payment rate starting in 2024. Sec. 302 encourages the kidney care workforce in underserved areas by including renal dialysis in the definition of primary care services and allowing nephrology health professionals to participate in the National Health Service Corps Scholarship and Loan Repayment programs.

TITLE IV, Expanding Patient Choice of Coverage: Sec. 401 guarantees Medigap coverage availability for all ESRD Medicare beneficiaries, regardless of age, and establishes a one-time enrollment period from January 1, 2023, to June 30, 2023, for eligible individuals to enroll in a Medigap policy.