NN&I - April 2010
National 10 Nephrology News & Issues April 2010www.nephronline.com A two-day conference organized by the Centers for Medicare & Medicaid Services to consider new clinical per -formance measures has generated pos -itive responses from both CMS and renal community members. One CMS official described the dis-cussion as "very productive and a lot of energy. There were 30-plus possibilities that came out of the meetings over the last two days." CMS assembled Technical Expert Panels to consider six new CPMs. The panels were manned by renal profes-sionals, patients, and industry experts. The possible CPMs included anemia management (target value for serum ferritin and transferrin saturation); min -eral metabolism (target value for cal- cium and phosphorus);vascular access (catheter infection rate); pediatric ade-quacy (HD and PD); pediatric anemia, and fluid weight management. TEP members had to determine if new CPMs were feasible for these clinical indications, based on scientific acceptability, feasibility, and usability. An additional Data TEP will be held April 26-27 to review data elements and data sources required for the proposed measures. A report on the outcome of the TEP panels is expected this month. Some of the suggestions included: Make Medicare eligibility for \037 patientsand reimbursement to pro -viders automaticif a pre-ESRD or dialysis patient receives a fistula Avoid sodium modeling and make all \037 dialysis treatments a minimum of four hours. Once the CPMs are final, CMS expects to submit them to the National Quality Forum this fall for review.CMS encouraged by input from TEP sessions NKF launches new education program for CKD patientsThe National Kidney Foundation has developed a curriculum to assist pro-fessionals in providing pre-dialysis education for individuals in Stage 4 CKD. (See story, page 20) Compiled by Mark E. NeumannRPA revises recommendations for EPO use DaVita files motion to dismiss whistleblower suit Buettner steps downIn anticipation of CMS's review of eryth-ropoiesis-stimulating agents among chronic kidney disease patients at a March 23 meeting, the Renal Physician Association released an update on its recommendations for treating anemia at it annual meeting last month. In its update, the RPA said: ESA treatment in nondialysis CKD \037 patients to a target Hgb>13 gm/dl has been found to increase cardiovascu -lar and other risks, without consistent signs of benefit. ESA treatment in nondialysis CKD \037 to target Hgb 10-13 gm/dl has not been adequately tested, so no clear treat -ment recommendations can be made in this range. Practitioners should consider their patient's clinical char -acteristics, and include the patient in consideration of potential benefits and risks of ESA treatment in this range. The RPA acknowledged a recently pub-lished literature review of prospective studies examining energy and physical function in CKD patients with anemia in this range "showing that treatment of anemia with ESAs improves both of these measures." ESA use for nondialysis CKD patients \037 with Hgb<10 gm/dl reduces the need for transfusions and may improve patient reported outcomes. Particularly for patients who are candidates for kidney transplantation, avoiding blood trans -fusions may reduce presensitization and improve the likelihood of finding a good donor-recipient match. The association also offer guidelines for patients with profound anemia. To read the complete set of recommenda-tions, go to www.renalmd.org. DaVita Inc. filed a motion on March 5 to dismiss a whistleblower suit, brought on by a former Amgen employee that alleges the company over administered Epogen to gain bigger discounts. In the motion, the dialysis provider The American Association of Kidney Patients announced on March 16 the resignation of its Executive Director, Kim Buettner. Buettner has accepted a position within the Education and Patient Advisory Program of a large Tampa based cancer treatment and research center. Buettner joined AAKP in 1994 and for five years served as the commu- nications director. In 2007 she was promoted to assistant director and in 2009 became executive director, replacing the late Kris Robinson. says the complaint does not meet any of the requirements necessary to allege fraud in a false claims act. DaVita says the complaint does not name any par -ticipants, does not identify any spe- cific scheme, and violates the statutes of limitations and mandatory sealing requirements of a false claims act. National_NNI0410_5.indd 10 3/18/10 4:12:45 PM
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