Bill > S2730

This bill aims to improve kidney care access and innovation within the Medicare program by implementing several key provisions. The bill extends the Transitional Drug Add-on Payment Adjustment (TDAPA) period to at least 3 years for new renal dialysis drugs or biological products approved after January 1, 2020, and introduces a permanent post-TDAPA adjustment mechanism that will provide ongoing financial support for innovative treatments. It clarifies the definition of renal dialysis services to exclude drugs treating comorbid conditions and expands the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) to include breakthrough devices and capital-related assets. Additionally, the bill ensures that Medicare Advantage plans will make direct payments to providers for new renal dialysis drugs, biological products, and innovative equipment. A final provision addresses payment accuracy by introducing a forecast error adjustment mechanism for the End-Stage Renal Disease (ESRD) prospective payment system, which will help account for differences between predicted and actual treatment costs. These changes are designed to support healthcare providers, encourage medical innovation, and improve treatment options for patients with kidney disease, with most provisions taking effect on January 1, 2026.

Budget and Finance

https://www.congress.gov/bill/119th-congress/senate-bill/2730/all-info