Kidney Care Access Protection Act

This bill aims to help people on dialysis get new medicines and devices more quickly and keep clinics stable. It lets Medicare pay extra for new kidney drugs and equipment for at least three years while they roll out. After that, Medicare would keep a smaller, ongoing add-on to cover part of the cost of these new treatments, adjusted each year for inflation and not offset by other cuts . It also requires similar support in Medicare Advantage by sending direct payments to dialysis providers for these new therapies, in the same amounts and for the same time period as in regular Medicare, starting in 2026 . The bill extends special payments for new dialysis devices, makes breakthrough devices eligible, and allows payments to include big equipment costs, beginning in 2026 . To help clinics with staffing and rising costs, it adds a “forecast error” fix so yearly payment updates better match real-world prices when projections miss by more than 0.5 percentage points .

Most changes take effect January 1, 2026, with some add-ons tied to drugs used on or after January 1, 2024, once the ongoing add-on starts in 2026 .

• Who is affected: People with end-stage kidney disease using dialysis; dialysis clinics; Medicare and Medicare Advantage plans .
• What changes: Extra payments for new drugs and devices during early use, then a smaller permanent add-on (about 65% of the calculated amount), with yearly inflation updates; direct payments in Medicare Advantage; expanded eligibility for innovative devices; and a fix to keep clinic payments in line with actual costs .
• When: Mostly starts January 1, 2026; some drug-related add-ons consider use from January 1, 2024, once the permanent add-on begins in 2026 .