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 U.S. Representative Debbie Dingell (D-MI-06), alongside U.S. Representatives Rudy Yakym (R-IN-02), Brad Schneider (D-IL-10), and Mariannette Miller-Meeks (R-IA-01), introduced legislation to expand Medicare coverage for remote patient monitoring services furnished by nephrologists to individuals with end stage renal disease receiving home dialysis. The bipartisan legislation is called the Keeping Individuals with Dialysis Needs Equipped through Year-round Remote Monitoring Act, known as the KIDNEY Remote Monitoring Act.

“Kidney disease remains a serious and widespread health concern across the United States and demands more innovative care solutions,” Congresswoman Dingell said. “This legislation will help patients stay healthier, reduce costly appointments, and ensure they receive the treatment they need at a price they can afford. It will modernize life-saving care and make it more affordable, accessible, and effective.” 

End stage renal disease (ESRD) affects hundreds of thousands of Americans, many of whom manage their condition through home dialysis. Research shows remote patient monitoring (RPM) meaningfully improves outcomes for these patients, including a 45 percent lower rate of all-cause mortality, a 51 percent lower rate of cardiovascular-related deaths, and a 69 percent lower rate of hospitalizations from fluid overload. RPM has also been shown to reduce one to two hospitalizations, and two to five emergency room visits per patient annually, producing roughly $23,000 in cost savings per patient.

Despite these benefits, a Medicare billing quirk discourages nephrologists from using RPM. Cardiologists, endocrinologists, nephrologists, and other specialists can bill RPM through Medicare Part B for patients with chronic kidney disease. But when their disease progresses and they are diagnosed with ESRD, Medicare folds the cost of RPM into the Monthly Capitation Payment within the ESRD bundle, effectively limiting access to this technology. The KIDNEY Remote Monitoring Act corrects this disparity, allowing remote physiologic monitoring ordered by a nephrologist to be reimbursed outside the capitated payment bundle, ensuring better access to remote monitoring for patients with ESRD. 

“Home dialysis patients deserve access to the same tools other Medicare patients already benefit from,” Congressman Yakym said. “Right now, a cardiologist and a nephrologist can order the exact same remote monitoring service for the same patient, but only one of them gets reimbursed fairly for it. The KIDNEY Remote Monitoring Act is a commonsense fix that removes a bureaucratic barrier and better serves patients.”

“Expanding Medicare coverage for remote patient monitoring will strengthen kidney care to improve patient outcomes,” Congressman Schneider said. “I am proud that companies like Vantive Health – headquartered right here in my district – are at the forefront of developing and delivering this cutting-edge remote monitoring technology. The KIDNEY Remote Monitoring Act will ensure Medicare coverage for device setup, patient education, and the secure transmission of health data to physicians, providing reliable care for patients from the safety and comfort of their homes.”

“As a physician, I’ve seen how early intervention can make all the difference for patients with complex conditions like ESRD,” Congresswoman Miller-Meeks said. “Remote monitoring allows providers to stay connected to patients in real time, improving care and reducing costly complications. This is a commonsense step to modernize care and support patients on home dialysis.”