In the News

U.S. Reps. Mike Kelly (R-Penn.) and Suzan DelBene (D-Wash.) have introduced the Concurrent Care for Comfort Act, designed to ensure that hospice patients can receive dialysis treatment.

The Concurrent Care for Comfort Act would clarify Medicare coverage policies for palliative dialysis and establish separate reimbursement for these services when provided by renal dialysis facilities and other qualified providers to certain individuals who have elected hospice care.

“At the end-of-life, patients with kidney failure often have to choose between hospice care or continuing dialysis, making them half as likely to receive hospice care than patients with other end-stage diagnoses,” said DelBene in a statement. “Hospice care is meant to provide comfort and dignity for people nearing the end of life, but for patients in kidney failure this decision is much more complicated. Our bipartisan bill addresses this issue and ensures patients have access to therapies that improve comfort at the end of life.”

Many hospice patients with end-stage renal disease (ESRD) are asked to give up dialysis when enrolling in the benefit. This contributes to low utilization for those patients compared to those with other diagnoses like cancer and dementia-related illnesses.

Only 1.3% of Medicare decedents who received hospice care in 2024 had a primary diagnosis of ESRD, according to the National Alliance for Care at Home.

“The Concurrent Care for Comfort Act gives patients greater choice and accessibility to care while they receive their critical dialysis treatments,” said Kelly. “It’s a practical solution for both patients in what is often one of the most trying times of their life.”

This is not the first legislative attempt to address access to dialysis for hospice patients. The recently reintroduced Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act also proposes to develop a payment mechanism for high-acuity palliative services, including dialysis, transfusions, radiation and chemotherapy.

The U.S. Centers for Medicare & Medicaid Services (CMS) has also mulled options for addressing high-acuity palliative services. The agency included requests for information on this concern in its 2024 and 2025 proposed hospice rules.

“Medicare patients with ESRD deserve a choice in all aspects of their care, including end-of-life”, said Monica Massaro, executive director of the Nonprofit Kidney Care Alliance (NKCA), in a statement. “NKCA is grateful to Representatives Kelly and DelBene for their leadership in sponsoring the Concurrent Care for Comfort Act, which will provide a dignified end-of-life experience for patients and their families.”