Medicare dialysis payment rules would shift under HR 6214

What does this do?

HR 6214 extends the temporary payment period for new dialysis drugs and devices from two to at least three years, after which dialysis centers receive a permanent extra payment equal to 65 percent of actual drug costs, adjusted annually for inflation. The bill also requires Medicare Advantage plans to follow the same payment rules as traditional Medicare for these treatments. Separately, it corrects errors in how Medicare calculated annual dialysis payment rate updates going back to 2021 and 2022.

Who does it affect?

Approximately 800,000 Americans on Medicare with end-stage renal disease and the dialysis centers that treat them are most directly affected. Older Medicare enrollees who have not yet reached end-stage kidney disease may also be affected through expanded annual wellness screenings beginning in 2026.

Why does it matter?

Dialysis centers would have stronger financial incentives to offer newer drugs and devices, which could affect how quickly patients gain access to those treatments. Expanding kidney disease screening during annual wellness visits and broadening education sessions to include stage V patients, while also allowing nurse practitioners and physician assistants to provide those sessions, changes who delivers and receives certain Medicare services.

What does it cost, and who pays?

• 65% of new drug costs as add-on payment
• Inflation adjustment applied each year
• Past rate errors from 2021–2022 corrected