Medicare locks in permanent dialysis drug markups—no cost controls attached
S. 2730 — Kidney Care Access Protection Act · Filed by Marsha Blackburn (R-TN) · 2 cosponsors · Introduced Sep 8, 2025 · Referred to committee
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What it does
This bill extends and expands Medicare payment protections for new kidney dialysis drugs, biologics, and equipment. It guarantees that new dialysis drugs approved since 2020 receive temporary price add-ons for at least 3 years, then a permanent 65% add-on payment after that period ends. It also extends similar protections to new dialysis equipment and makes Medicare Advantage plans match these payments. The bill aims to ensure dialysis providers can afford to offer newer treatments without budget cuts elsewhere.
Why we flagged it
The bill's core function is to lock in above-market reimbursement rates for dialysis drugs and equipment by establishing permanent add-on payments that are not subject to budget-neutral adjustments or cost-effectiveness review. This directly benefits dialysis providers and pharmaceutical manufacturers.
What the text implies
- The 65% permanent add-on is calculated from utilization and average sales price but is NOT adjusted for clinical efficacy, comparative effectiveness, or whether the new drug is actually better than existing options—only that it is 'new.'
- The bill explicitly exempts the permanent add-on from 'budget neutral' adjustments and case-mix adjustments, meaning costs are NOT offset by reductions elsewhere in the ESRD payment system, creating direct Medicare spending increases.
The full analysis lists 5 implications of this text.
Who stands to gain
dialysis service providers (DaVita, Fresenius Medical Care, Renal Care Group); pharmaceutical manufacturers (Amgen, Vifor Pharma, Keryx Biopharmaceuticals, others with ESRD drugs); dialysis equipment manufacturers