Summary of The Kidney Care Quality and Education Act

IMPROVING QUALITY THROUGH PATIENT EDUCATION, ACCESS, AND SAFETY INITIATIVES

Provides $2 million to fund a 5-year demonstration project in at least 3 States to increase public awareness of how to prevent and treat chronic kidney disease and to assess its prevalence and incidence.  Provides $2 million to fund a 5-year demonstration project in at least 3 States to help individuals with kidney disease develop self-management skills.

Amends § 1861(s)(2) of the Act to provide coverage for kidney disease education services furnished upon a managing physician’s referral to Medicare beneficiaries with chronic kidney disease who will require dialysis or a kidney transplant.  Limits the services to six educational sessions per individual.

Provides $1 million for a 5-year demonstration project evaluating how blood flow monitoring affects the quality and cost of care for medicare beneficiaries with ESRD.

Provides for an Institute of Medicine study to evaluate and report on any barriers to increasing the number of individuals with ESRD who receive home dialysis services or other treatment modalities under Medicare.

Amends § 1881 of the Act to require that, beginning Jan. 1, 2008, patient care dialysis technicians receive training and certification and are competent to provide dialysis-related services.   These technicians must repeat training or become re-certified if 24 consecutive months pass during which they have not performed dialysis-related services.  Service providers and renal dialysis facilities will provide performance reviews and in-service education to assure competency.

ASSURING QUALITY OF CARE FOR PROVIDERS, FACILITIES, AND PHYSICIANS THAT PROVIDE SERVICES FOR INDIVIDUALS WITH END-STAGE RENAL DISEASE WHO ARE ENROLLED IN PART B

Establishes an ESRD advisory committee to provide a forum for expert discussion and provide annual recommendations about selecting and updating clinical and quality of life measures, modifying the payment structure, determining hardship criteria to exempt certain facilities and providers from the program, and other issues related to implementation of a quality initiative to the Secretary of the Department of Health and Human Services (HHS). The committee will also provide periodic reports to the Secretary about other issues related to the Medicare ESRD program.

Establishes an annual increase in the composite rate for dialysis facilities for 2008, 2009, and 2010 equal to the CMS-developed ESRD market-basket amount for those years.

Establishes a 3-year Continuous Quality Improvement Initiative that provides payments for meeting quality benchmarks and demonstrating quality improvements to independent dialysis facilities, hospital-based providers, and physicians who provide services to Medicare ESRD beneficiaries.  Pediatric providers receive a full market basket update for the first three years of reporting data for pediatric-specific measures.  Quality bonus payments are funded by providing an update to the composite rate for dialysis facilities and by including physicians in the demonstration project only if there is a fix to the physician conversion factor.  From one-quarter up to one-half of the annual update for these facilities, providers, and physicians would be set aside to fund the quality bonus pool.   The payments would be awarded during the first year for reporting and tied to a composite quality score in years two and three.  The Centers for Medicare and Medicaid Services, the Institute of Medicine, and the Medicare Payment Advisory Commission will evaluate the program and report to Congress about its effectiveness.  Low-performing facilities and providers will receive technical assistance to help them improve their performance.  CMS will consolidate all current data reporting systems and develop a web-based system.  There would be public reporting of the composite scores. 

Amends § 1862(b)(1)(C) of the Act by extending the Medicare Secondary Payer requirement by an additional three months; requires the OIG to report to Congress on the enforcement of the existing anti-discrimination provision protecting patients with kidney failure.