August 2011


Dear Friend,

Thank you for your commitment to the American Kidney Fund’s Advocacy Network!  As an AKF Advocate, you have the opportunity to join with others to make a difference in the lives of all kidney patients.

This month, we’re pleased to provide you with an update on some key regulations affecting dialysis patients. AKF tracks regulatory developments closely and provides comment to agencies when issues arise that may impact people with kidney disease. Keeping policymakers and regulators informed is an important aspect of the fight against kidney disease.

With the help of our dedicated advocates, the American Kidney Fund will have a strong voice with legislators and policymakers whose decisions affect people living with kidney disease. 

From all of us at AKF, thank you for your time and dedication!


Nikia Okoye
Director of Government Relations

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Senior Couple with Laptop

HHS Releases Health Insurance Exchange Regulations

On July 11, the Department of Health and Human Services (HHS) released its first proposed regulations for state health insurance exchanges.  Health exchanges were created as part of health care reform, the Affordable Care Act (ACA), to enable individuals and small businesses to more easily compare health insurance choices among providers and determine eligibility for health programs and tax credits.  The ACA mandated the exchanges be operational by January 1, 2014.

The American Kidney Fund is focused on ensuring that kidney patients continue to have access to affordable healthcare under the exchanges.  AKF will continue to monitor this issue and will file comments; further regulations are expected later this year. For more information, please visit AKF's Advocacy website.

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Hundred-dollar bills

CMS Releases Proposed Regulations for
Bundled Payment System in 2012

On July 1, the Centers for Medicare and Medicaid Services (CMS) issued its Proposed Rule for the ESRD bundled payment system in 2012.  Under the proposed updates, dialysis facilities would see a 1.8 percent increase in base-rate payments in 2012.  CMS calculated the increase based on the changes over time in the prices of goods and services needed to provide dialysis services, and adjusted that amount to keep payments in line with overall economic productivity.

Additionally, CMS is not proposing a transition adjuster in 2012.  For 2011, after underestimating the number of facilities that would opt for payment under the bundled system, CMS initially instituted a 3.1 percent transition adjuster that would have significantly reduced payments to dialysis facilities.  After efforts by AKF and the renal community, the transition adjuster for 2011 was eliminated earlier this year.

AKF will continue to monitor this issue and will file comments to ensure that patient interests are protected; a 60-day public comment period ends on August 30, 2011. For more information, please visit AKF's Advocacy website.

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Doctor and Patient

CMS Proposes Updates to ESRD QIP
in 2013 and 2014

On July 1, CMS also proposed updates to its performance measures under the ESRD Quality Incentive Program (QIP) for payment years 2013 and 2014.  The ESRD QIP is a Medicare savings program that will reduce payments by up to two percent to dialysis facilities who fail to meet certain performance measures.  Performance measures during the first year of the ESRD QIP (2012) include a target hemoglobin range of 10–12 g/dL, and a hemodialysis adequacy measure.

CMS is proposing to eliminate the bottom level of the target hemoglobin range from its performance measures in 2013 to coincide with recent recommendations from the U.S. Food and Drug Administration (FDA) on erythropoiesis-stimulating agent (ESA) use in kidney patients.  The FDA released findings in June that showed ESA use by kidney patients can lead to increased risks of stroke, adverse cardiovascular reactions and death.  Accordingly, ESA labels now instruct doctors to use lower doses of ESAs based on a patient’s individual needs, rather than to meet a target hemoglobin range. 

For 2014, CMS has proposed a total of eight performance measures, including new clinical measures to evaluate a facility’s patient infection and hospitalization rates, as well as non-clinical measurements such as evaluating whether a facility provides a patient experience survey. 

AKF supports the establishment of the ESRD QIP and will continue to monitor the implementation of QIP and consideration of future measures.  AKF will file comments on the rule. For more information, please visit AKF's Advocacy website.

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2011 Cal Kids cover art for 2012 calendar

AKF Announces Winners of Calendar Kids
Art Contest

The American Kidney Fund recently announced the winners of its 16th annual “Calendar Kids” art contest.  Each year, AKF recognizes children with kidney disease for their artistic talent and distributes the calendars nationwide to help increase awareness of kidney disease. 

This year’s cover winner, Danielle L., 13, of Hendersonville, Tenn., was selected through an online voting process that garnered over 3,600 votes.  Danielle’s drawing (pictured) is a vivid depiction of the holiday she loves the most: Halloween. The colorful pumpkin and moth are decorated with the American Kidney Fund’s circular logo.  Danielle will receive an all-expenses-paid trip to Washington, D.C., to be honored at AKF’s annual gala, The Hope Affair.  Each of the 13 winners will receive a netbook computer and a $1,000 education savings bond.

For more information including a list of all of this year’s winners, please visit

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 DC Steps that Count 2011

Upcoming Events

AKF will host three more Kidney Action Days in 2011 featuring our Steps that Count walkathons, free kidney health screenings, and fun family activities.  These events will be held:

October 1 – San Antonio (AT&T Center)
October 16 – Houston (Discovery Green Park)
November 12 – Atlanta (Turner Field)

For more information and to register for Steps that Count, please visit

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World Kidney Day on Capitol Hill

We Want Your Feedback

Do you want to know more about a particular federal regulation or piece of legislation? Do you have a story you would like to share about your fight with kidney disease? Let us know what information is helpful to you as a kidney patient, caregiver or volunteer.

Feel free to contact Michael Platt, Government Relations Assistant, at or call the Government Relations team toll free at (800) 638-8299, and don’t forget to encourage your family and friends to sign up as AKF Advocates!