March 20, 2024 

Press Release

Washington D.C. – Today, Congresswoman Carol Miller (R-WV) questioned Health and Human Services (HHS) Secretary Xavier Becerra on how HHS can improve health care access for Americans, regardless of their condition.
Congresswoman Miller began by highlighting the positive work HHS has done regarding End Stage Renal Disease (ESRD), but also voiced concerns with the Centers for Medicare and Medicaid Services’ (CMS) refusal to allow patients with Acute Kidney Injury to be reimbursed for home dialysis.

“West Virginia has the highest mortality rate in the country for patients with kidney disease. I have focused much of my energy within the health care space on advocating for patients with chronic kidney disease and ESRD and I’ve been happy to be able to discuss these issues with you in the past. Last year, I led a letter with Congressman Blumenauer about the need for a pediatric ESRD modifier within the ESRD payment bundle, and I was very pleased when your agency took our advice and created one. I am excited to see how this improves care for children with ESRD. I also led a letter last year with Congresswoman DelBene about the need for Medicare coverage of home dialysis for patients with Acute Kidney Injury (AKI). Many patients with AKI are at the beginning of their kidney disease journey – studies show that almost 50% of patients with AKI never regain kidney function. Just last week, this committee heard powerful testimony from a home dialysis patient about the absolute life-changing potential of home dialysis. For these reasons, I am concerned by CMS’ decision not to allow home dialysis for patients with AKI, which does not seem aligned with HHS’ overall goal of increasing home dialysis uptake. How are you working to ensure that CMS’ policies around AKI patients are aligned with HHS’ overall goal of increasing home dialysis?” asked Congresswoman Miller.

“Congresswoman, thank you for your deep work on this issue, because for many folks this is life and death. We have to make sure that when we’re extending access to some of these services through the Medicare or Medicaid programs that we do it right, because taxpayer dollars are involved. We’ve been taking comment from the AKI community, and we will continue to do so. I will take back your comments today to our folks at CMS so we can follow up with your team. We’re not done [working on this issue] and this is an issue I know you’re not going to stop working on this. At the end of the day, the quicker and better we get services to these families, the less it’s going to cost taxpayers,” responded Secretary Becerra.

“Thank you for your commitment to kidney disease patients. I look forward to continuing to work together on these issues,” said Congresswoman Miller. 
Congresswoman Miller ended her questioning by voicing concern with a recent CMS rule regarding the Medicare Advantage enrollment process. 

In West Virginia, about half of Medicare beneficiaries receive coverage through Medicare Advantage. Your department recently cleared a CMS rule that is waiting for White House approval that would overhaul the Medicare Advantage enrollment process. 14 Members of the Ways and Means Committee, including myself, sent you a letter on January 12 on the proposed rule. Like you, we are concerned about bad actors and aggressive marketing practices that cause headaches for seniors. We also believe seniors need resources to decide which plan to enroll in. But your proposal would limit resources in the enrollment market for everyone – not just the bad actors. Would you commit to me that CMS will not reduce enrollment resources or limit the ability of agents and brokers to help beneficiaries find Medicare Advantage plans that best fit their needs?” asked Congresswoman Miller. 

“Let me commit to you to work with you on that issue. We want to make sure that people are steered to what plans and services they need, and we want to make sure that it is to the benefit of a patient that they end up in a particular type of plan or service. [I am] more than willing to work with you to address that because you and I both have the patient’s best interests in mind,” responded Secretary Becerra.

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